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NPI 1992847099

OrganizationActive

Coastal Medical, Inc.

NPI 1992847099 · Non-Pharmacy Dispensing Site · Johnston, RI

Provider details

NPI number: 1992847099
Entity type: Organization
Primary specialty: Non-Pharmacy Dispensing SiteSuppliers
Parent organization: Medvantx,inc.
Authorized official: Kenny Heine, Dir. of Operations
License: MD05547 (RI)

Practice location

1524 Atwood Ave

Ste. 340

Johnston, RI 02919-3228

Phone: (401) 949-0300

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 1992847099, Johnston, RI | NPI Central