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Coastal Medical, Inc. — NPI 1720128499, Wakefield, RI | NPI Central

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NPI 1720128499

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Coastal Medical, Inc.

NPI 1720128499 · Non-Pharmacy Dispensing Site · Wakefield, RI

Provider details

NPI number: 1720128499
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: MD06582 (RI)

Specialties & taxonomies

Non-Pharmacy Dispensing SitePrimary332900000XLicense MD06582 (RI)
Suppliers

Practice location

70 Kenyon Ave

Suite 321

Wakefield, RI 02879-4239

Phone: (401) 783-0084

Fax: (401) 782-0005

Approximate (ZIP-level) locationGet directions

More RI providers

Mailing address

5626 Oberlin Dr

San Diego, CA 92121-1705

Other names (DBA / former)

Doing business as: Coastal Medical - Wakefield Medical

Registry dates

Enumerated: 2007-02-08
Last updated: 2013-04-24

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