Organization
COASTAL MEDS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICKEY CHANCE (CORPORATE OFFICER/OWNER)
(228) 388-1327
Entity
Organization
Contact information
Practice address
1759 MEDICAL PARK DR, SUITE C, BILOXI, MS 39532-2154
(228) 388-1327
(228) 388-1329
Mailing address
1759 MEDICAL PARK DR, SUITE C, BILOXI, MS 39532-2154
(228) 388-1327
(228) 388-1329
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
Primary
07783/02.2
MS
Other
Enumeration date
02/04/2013
Last updated
02/04/2013
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