Organization
GOLD COAST MEDICAL SERVICES INC
Active
Organization
GOLD COAST MEDICAL SERVICES INC
Active
Other names
GOLD COAST MEDICAL SERVICES, INC.
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY WADSWORTH (PRESIDENT)
(707) 443-2907
Entity
Organization
Contact information
Practice address
1551 NURSERY RD, MCKINLEYVILLE, CA 95519-3982
(707) 633-6183
(707) 633-6184
Mailing address
1551 NURSERY RD, MCKINLEYVILLE, CA 95519-3982
(707) 633-6183
(707) 633-6184
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY42086
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0538629
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
PHA420860
—
CA
Enumeration date
01/30/2007
Last updated
02/11/2011
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