Southern Cancer Center, PC

Primary specialty

PharmacyTaxonomy code 333600000X

Legal business name

SOUTHERN CANCER CENTER, PC

Doing business as

Coastal Pharmacy LLC
Southern Cancer Center, PC dba Coastal Pharmacy LLC

Practice address

29653 Anchor Cross Blvd
Sutie a 101
Daphne, AL 36526-9594

Phone

(251) 607-5061

Fax

(251) 607-5062

NPI assigned

Jan 30, 2013

Last updated

Sep 29, 2025By 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

Lauren Pettis

Title

Executive Director

Phone

(251) 625-6896

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 2

• Coastal Pharmacy LLC Doing business as
• Southern Cancer Center, PC dba Coastal Pharmacy LLC Doing business as

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Southern Cancer Center, PC

  • Medical Oncology Physician
  • Mobile, AL
  • NPI 1578629556

  5597860403

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Tax ID family

Coastal Pharmacy LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Southern Cancer Center, PC

  dba Coastal Pharmacy Springhill

  • Pharmacy
  • Mobile, AL
  • NPI 1568142099
  NPD tax ID
• Southern Cancer Center, PC

  dba Coastal Pharmacy Providence

  • Pharmacy
  • Mobile, AL
  • NPI 1962282178
  NPD tax ID

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Southern Cancer Center, PC

  dba Coastal Pharmacy Springhill

  • Pharmacy
  • Mobile, AL
  • NPI 1568142099

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1359504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759104000000",
    "number": "1619215381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29653 ANCHOR CROSS BLVD STE A101",
            "city": "DAPHNE",
            "state": "AL",
            "postal_code": "365269594",
            "telephone_number": "251-607-5061",
            "fax_number": "251-607-5062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29653 ANCHOR CROSS BLVD",
            "address_2": "SUTIE A 101",
            "city": "DAPHNE",
            "state": "AL",
            "postal_code": "365269594",
            "telephone_number": "251-607-5061",
            "fax_number": "251-607-5062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN CANCER CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-30",
        "last_updated": "2025-09-29",
        "certification_date": "2025-09-29",
        "status": "A",
        "authorized_official_last_name": "PETTIS",
        "authorized_official_first_name": "LAUREN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "251-625-6896"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "0138455",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coastal Pharmacy LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Coastal Pharmacy LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Southern Cancer Center, PC dba Coastal Pharmacy LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Pharmacy in Daphne, AL
• Providers in Daphne, AL by specialty
• Pharmacy in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.