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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