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NPI 1114069218

OrganizationActive

Coastal Medical, Inc.

NPI 1114069218 · Non-Pharmacy Dispensing Site · Middletown, RI

Provider details

NPI number: 1114069218
Entity type: Organization
Primary specialty: Non-Pharmacy Dispensing SiteSuppliers
Parent organization: Medvantx,inc.
Authorized official: Kenny Heine, Dir. of Operations
License: MD07724 (RI)

Practice location

850 Aquidneck Ave

Middletown, RI 02842-7244

Phone: (401) 846-0055

More RI providers

Mailing address

5626 Oberlin Dr

San Diego, CA 92121-1705

Registry dates

Enumerated: 2007-02-13
Last updated: 2012-10-17

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.

Coastal Medical, Inc. — NPI 1114069218, Middletown, RI | NPI Central