Organization
COASTAL PHARMACY SERVICES LLC
Active
Parent organization
COASTAL PHARMACY SERVICES, LLC
Other names
Coastal Pharmacy Services, Coastal Infusion 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
190 GREENBRIER BLVD STE 105, COVINGTON, LA 70433-7237
(985) 900-2416
(985) 900-2436
Mailing address
1922 HIGHWAY 22 W STE A, MADISONVILLE, LA 70447-9490
(985) 792-9001
(985) 792-9004
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2206672
—
LA
Enumeration date
02/20/2019
Last updated
12/03/2019
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