Organization
COASTAL PHARMACY SERVICES LLC
Active
Other names
Coastal Pharmacy Services
Organization subpart
No
Provider details
NPI number
Authorized official
HUNTER FARRAR PHARMD (CEO & FOUNDER)
(985) 900-4857
Entity
Organization
Contact information
Practice address
1922 HIGHWAY 22 W STE A, MADISONVILLE, LA 70447-9490
(985) 792-9001
(985) 792-9004
Mailing address
1922 HIGHWAY 22 W STE A, MADISONVILLE, LA 70447-9490
(985) 792-9001
(985) 792-9004
Taxonomy
Speciality
Code
Description
License number
State
251F00000X
Home Infusion Agency
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
333600000X
Pharmacy
—
—
3336H0001X
Home Infusion Therapy Pharmacy
PHY.007511-IR
LA
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2170909
PK
—
05
—
2206672
—
LA
Enumeration date
08/03/2017
Last updated
05/10/2019
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