Coast RX

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

COAST RX

Practice address

1105 Broad Ave
Gulfport, MS 39501-2415

Phone

(504) 301-6638

NPI assigned

Nov 13, 2025

Organization subpart

No

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

Authorized official

Name

Ryan Boudreau, PHARMDNPI 1346595998

Title

Manager

Phone

(504) 301-6638

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ryan James Boudreau, PHARMD

  • Pharmacist
  • Metairie, LA
  • NPI 1346595998
  NPD Authorized official

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

{
    "created_epoch": "1762992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762992000000",
    "number": "1346100336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 BROAD AVE",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395012415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 BROAD AVE",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395012415",
            "telephone_number": "504-301-6638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COAST RX",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-13",
        "last_updated": "2025-11-13",
        "certification_date": "2025-11-13",
        "status": "A",
        "authorized_official_last_name": "BOUDREAU",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "504-301-6638",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Retail Pharmacy in Gulfport, MS
• Providers in Gulfport, MS by specialty
• Community/Retail Pharmacy in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.