Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
SOUTHERN CANCER CENTER, PC
Active
Organization
SOUTHERN CANCER CENTER, PC
Active
Other names
Coastal Pharmacy Providence
Organization subpart
No
Provider details
NPI number
Authorized official
LAUREN PETTIS (EXECUTIVE DIRECTOR)
(251) 625-6896
Entity
Organization
Contact information
Practice address
6701 AIRPORT BLVD., 'B' BLDG., 'T' LEVEL, MOBILE, AL 36608-3764
(251) 607-5061
Mailing address
SOUTHERN CANCER CENTER, PC DBA COASTAL PHARM PROVIDENCE, 29653 ANCHOR CROSS BLVD., DAPHNE, AL 36526-9594
(251) 607-5061
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Enumeration date
10/04/2023
Last updated
10/04/2023
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up