Organization
COASTAL PHARMACY LLC
Active
Other names
Coastal Pharmacy & Wellness
Organization subpart
No
Provider details
NPI number
Authorized official
CASSI Q BROOKS (PRINCIPAL)
(207) 899-0886
Entity
Organization
Contact information
Practice address
29 MARGINAL WAY, SUITE 4, PORTLAND, ME 04101-1914
(207) 899-0886
(207) 899-0826
Mailing address
29 MARGINAL WAY, SUITE 4, PORTLAND, ME 04101-1914
(207) 899-0886
(207) 899-0826
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0004X
Compounding Pharmacy
Primary
—
—
Other
Enumeration date
11/04/2008
Last updated
05/07/2019
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