Coastal Pain Management Delray Dispensary

Primary specialty

Non-Pharmacy Dispensing SiteTaxonomy code 332900000X

License

ME62450 Issued in FL

Legal business name

COASTAL PAIN MANAGEMENT DELRAY DISPENSARY

Practice address

75 NE 6TH Ave
Suite #104
Delray Beach, FL 33483-5435

Phone

(561) 272-3880

NPI assigned

Jan 17, 2008

Last updated

May 7, 2008By the provider in NPPES

Organization subpart

Yes

Parent organization

PHYSICIANS CHOICE DISPENSING SERVICESAs reported in NPPES

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

Authorized official

Name

Ms. Cicely D Eason

Title

Executive Administrator

Phone

(561) 789-4911

Specialties & licenses 1

Addresses

Tax ID family

Coastal Pain Management Delray Dispensary2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Coastal Pain Management Pompano Dispensary

  • Non-Pharmacy Dispensing Site
  • Pompano Beach, FL
  • NPI 1245408830
  NPD tax ID

Locations

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

{
    "created_epoch": "1200528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210118400000",
    "number": "1629254818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4688",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333384688",
            "telephone_number": "954-376-7313",
            "fax_number": "954-697-0153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 NE 6TH AVE",
            "address_2": "SUITE #104",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334835435",
            "telephone_number": "561-272-3880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL PAIN MANAGEMENT DELRAY DISPENSARY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PHYSICIANS CHOICE DISPENSING SERVICES",
        "enumeration_date": "2008-01-17",
        "last_updated": "2008-05-07",
        "status": "A",
        "authorized_official_last_name": "EASON",
        "authorized_official_first_name": "CICELY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "EXECUTIVE ADMINISTRATOR",
        "authorized_official_telephone_number": "561-789-4911",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "FL",
            "license": "ME62450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Non-Pharmacy Dispensing Site in Delray Beach, FL
• Providers in Delray Beach, FL by specialty
• Non-Pharmacy Dispensing Site in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2008; 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.