Gold Coast Medical Services Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHY42086 Issued in CA

Legal business name

GOLD COAST MEDICAL SERVICES INC

Doing business as

Gold Coast Medical Services, Inc.

Practice address

1551 Nursery Rd
McKinleyville, CA 95519-3982

Phone

(707) 633-6183

Fax

(707) 633-6184

NPI assigned

Jan 30, 2007

Last updated

Feb 11, 2011By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Larry Wadsworth

Title

President

Phone

(707) 443-2907

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• GOLD COAST MEDICAL SERVICES, INC. Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297382400000",
    "number": "1003953241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1551 NURSERY RD",
            "city": "MCKINLEYVILLE",
            "state": "CA",
            "postal_code": "955193982",
            "telephone_number": "707-633-6183",
            "fax_number": "707-633-6184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1551 NURSERY RD",
            "city": "MCKINLEYVILLE",
            "state": "CA",
            "postal_code": "955193982",
            "telephone_number": "707-633-6183",
            "fax_number": "707-633-6184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLD COAST MEDICAL SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2011-02-11",
        "status": "A",
        "authorized_official_last_name": "WADSWORTH",
        "authorized_official_first_name": "LARRY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "707-443-2907"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY42086",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA420860",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "0538629",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GOLD COAST MEDICAL SERVICES, INC.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Garfield Beach CVS LLC (CVS Pharmacy #10513)
• Bryce William Gasaway
• Shoshoni Lee Viola Gensaw, MA
• Mel Alan Glaspey, C.M.T.
• Tania Goicuria-Diaz
• Angel Nicole Goodman
• Lindsey D Goodnow, DAOM, L.AC.
• Nina Bleue Goodwin, F.N.P.
• Laura Guerra, F.N.P.
• Sarah Catherine Haag, PH.D.

• Community/Retail Pharmacy in McKinleyville, CA
• Providers in McKinleyville, CA by specialty
• Community/Retail Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.