# COASTAL PAIN MEDICINE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902094485
- **Authorized official:** DR. CHRISTOPHER THOMAS GRUBB M.D. (MANAGER, DIRECT OWNER)
- **Authorized official phone:** (888) 418-0333

## Contact information

- **Practice address:** 2905 GROVELAND DR, GREENVILLE, NC 27858-7188
- **Practice address phone:** (888) 418-0333
- **Mailing address:** PO BOX 30692, GREENVILLE, NC 27833-0692
- **Mailing address fax:** (888) 418-0333

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | — | NC | — |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | NC | Yes |

## Other

- **Enumeration date:** 10/09/2007
- **Last updated:** 01/16/2008