Organization
COASTAL EXPRESS PHARMACY INC
Active
Other names
Coastal Express Pharmacy, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
MATT UMBS (CFO)
(949) 777-3100
Entity
Organization
Contact information
Practice address
3198 AIRPORT LOOP DR STE F, COSTA MESA, CA 92626-3407
(562) 997-2585
(562) 997-2391
Mailing address
3198 AIRPORT LOOP DR STE F, SUITE 102, COSTA MESA, CA 92626-3407
(562) 997-2585
(949) 777-0918
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PHY 53436
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2130233
PK
—
Enumeration date
10/28/2010
Last updated
10/01/2015
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