NPIMap

Organization Active NPI

Coastal Pharmacy LLC

  • Long Term Care Pharmacy
  • Titusville, FL
National Provider Identifier
1831603430
Registry record updated Nov 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
PH22782 Issued in FL
Legal business name
COASTAL PHARMACY LLC
Practice address
504 Garden St
Titusville, FL 32796-3405
Phone
(321) 747-0206
Fax
(321) 593-4319
NPI assigned
Nov 20, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2017

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

Authorized official

Name
Deepak Aggarwal, RPHNPI 1710184312
Title
Manager
Phone
(321) 747-0206

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X PH22782 FL Primary

Addresses

Primary practice location

504 Garden St
Titusville, FL 32796-3405

Mailing address

504 Garden St
Titusville, FL 32796-3405
Phone (321) 747-0206

Other identifiers 1

IdentifierTypeStateIssuer
032151600MedicaidFL

Other names 1

  • EAST COAST PHARMACY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Coastal Pharmacy LLC2 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.

Locations

504 Garden St
Titusville, FL 32796
Phone (321) 747-0206

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1511136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1511136000000",
    "number": "1831603430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 GARDEN ST",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327963405",
            "telephone_number": "321-747-0206",
            "fax_number": "321-593-4319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 GARDEN ST",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327963405",
            "telephone_number": "321-747-0206",
            "fax_number": "321-593-4319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-20",
        "last_updated": "2017-11-20",
        "status": "A",
        "authorized_official_last_name": "AGGARWAL",
        "authorized_official_first_name": "DEEPAK",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "321-747-0206",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "FL",
            "license": "PH22782",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "032151600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EAST COAST PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Titusville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2017; 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.