Organization
COASTAL PHARMACY SERVICES LLC
Active
Parent organization
COASTAL PHARMACY SERVICES, LLC
Other names
Coastal Pharmacy Services
Organization subpart
Yes
Provider details
NPI number
Legal business name
COASTAL PHARMACY SERVICES, LLC
Authorized official
DR. HUNTER FARRAR PHARMD (OWNER)
(985) 792-9001
Entity
Organization
Contact information
Practice address
3417 HARDY ST, HATTIESBURG, MS 39402-1502
(601) 910-7279
(601) 300-8049
Mailing address
1922 HIGHWAY 22 W STE A, MADISONVILLE, LA 70447-9490
(985) 792-9001
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336H0001X
Home Infusion Therapy Pharmacy
Primary
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2206672
—
LA
Enumeration date
02/20/2019
Last updated
03/24/2020
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