OrganizationActive
Coastal Medical, Inc.
NPI 1114124864 · Non-Pharmacy Dispensing Site · Providence, RI
Coastal Medical, Inc. is a Non-Pharmacy Dispensing Site organization in Providence, RI (NPI 1114124864).
Provider details
- NPI number
- 1114124864
- Entity type
- Organization
- Primary specialty
- Non-Pharmacy Dispensing SiteSuppliers
- Parent organization
- Medvantx, Inc
- Organization subpart
- Yes
- Authorized official
- Kenny Heine, Vp of Operations(858) 625-2990
- License
- MD08852 (RI)
Specialties & taxonomies
Suppliers
Profile Score
Detailed profile(89/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1075 Smith St
2nd Floor
Providence, RI 02908-2700
Phone: (401) 421-4400
Street-level locationGet directions
Mailing address
5626 Oberlin Dr
San Diego, CA 92121-1705
Other names (DBA / former)
- Doing business as
- Coastal Medical - Elmhurst
Registry dates
- Enumerated
- 2007-06-27
- Last updated
- 2013-10-24
Frequently asked questions
- What is Coastal Medical, Inc.'s NPI number?
- Coastal Medical, Inc.'s National Provider Identifier (NPI) is 1114124864, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Coastal Medical, Inc.?
- Coastal Medical, Inc. is classified in the NPPES registry as Non-Pharmacy Dispensing Site (Suppliers).
- Where is Coastal Medical, Inc. located?
- Coastal Medical, Inc.'s practice location on file with NPPES is 1075 Smith St, Providence, RI 02908-2700.
- What is Coastal Medical, Inc.'s phone number?
- The practice phone number listed in the NPPES registry for Coastal Medical, Inc. is (401) 421-4400.
- Who is the authorized official for Coastal Medical, Inc.?
- The authorized official listed on Coastal Medical, Inc.'s NPPES record is Kenny Heine, Vp of Operations. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Coastal Medical, Inc.'s NPI active?
- Yes — Coastal Medical, Inc.'s NPI (1114124864) is active in the NPPES registry as of the last update on 2013-10-24.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.