Organization
COASTAL SPECIALTY PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOAN ELLISON PHARMD (MGMR)
(850) 622-3313
Entity
Organization
Contact information
Practice address
2050 W COUNTY HIGHWAY 30A, M1-106, SANTA ROSA BEACH, FL 32459-0187
(850) 622-3315
Mailing address
2050 W COUNTY HIGHWAY 30A, M1-106, SANTA ROSA BEACH, FL 32459-0187
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
Other
Enumeration date
11/15/2012
Last updated
11/15/2012
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