| Coastal Pharmacy Services Llc | |
|
190 Greenbrier Blvd Ste 105 Covington LA 70433-7237 | |
| (985) 900-2416 | |
| (985) 900-2436 |
| Full Name | Coastal Pharmacy Services Llc |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 190 Greenbrier Blvd Ste 105, Covington, Louisiana |
| Authorized Official Name and Position | Hunter Farrar (OWNER) |
| Authorized Official Contact | 9857929001 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Coastal Pharmacy Services Llc 1922 Highway 22 W Ste A Madisonville LA 70447-9490 Ph: (985) 792-9001 | Coastal Pharmacy Services Llc 190 Greenbrier Blvd Ste 105 Covington LA 70433-7237 Ph: (985) 900-2416 |
| NPI Number | 1962968404 |
|---|---|
| Provider Enumeration Date | 02/20/2019 |
| Last Update Date | 12/03/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962968404 | NPI | - | NPPES |
| 2206672 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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