Organization
COASTAL MEDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH ALLEN JOHNSON (MANAGER)
(228) 388-1327
Entity
Organization
Contact information
Practice address
1759 MEDICAL PARK DR, STE. C, BILOXI, MS 39532-2154
(228) 388-1327
Mailing address
1759 MEDICAL PARK DRIVE, STE. C, BILOXI, MS 39532
(228) 388-1327
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
07783/2.2
MS
Other
Enumeration date
03/03/2014
Last updated
03/03/2014
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