Coastal Pharmacy Services LLC

Primary specialty

Home Infusion Therapy PharmacyTaxonomy code 3336H0001X

Legal business name

COASTAL PHARMACY SERVICES LLC

Doing business as

Coastal Pharmacy Services

Practice address

3417 Hardy St
Hattiesburg, MS 39402-1502

Phone

(601) 910-7279

Fax

(601) 300-8049

NPI assigned

Feb 20, 2019

Last updated

Mar 24, 2020By the provider in NPPES

Organization subpart

Yes

Parent organization

COASTAL PHARMACY SERVICES, LLCAs reported in NPPES

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

Authorized official

Name

Dr. Hunter Farrar, PHARMDNPI 1275932535

Title

Owner

Phone

(985) 792-9001

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Coastal Pharmacy Services Doing business as

Tax ID family

Coastal Pharmacy Services LLC2 organizations share this tax ID, including this one

Part of

Coastal Pharmacy Services LLC

Other organizations with this tax ID 1

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

• Coastal Pharmacy Services LLC

  dba Coastal Infusion Services

  • Multi-Specialty Clinic/Center
  • Covington, LA
  • NPI 1962968404
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Hunter Farrar, PHARM.D.

  • Pharmacist
  • Madisonville, LA
  • NPI 1275932535
  Authorized official Same address or phone

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

{
    "created_epoch": "1550620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585008000000",
    "number": "1881150324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1922 HIGHWAY 22 W STE A",
            "city": "MADISONVILLE",
            "state": "LA",
            "postal_code": "704479490",
            "telephone_number": "985-792-9001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3417 HARDY ST",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394021502",
            "telephone_number": "601-910-7279",
            "fax_number": "601-300-8049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL PHARMACY SERVICES LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COASTAL PHARMACY SERVICES, LLC",
        "enumeration_date": "2019-02-20",
        "last_updated": "2020-03-24",
        "certification_date": "2020-03-24",
        "status": "A",
        "authorized_official_last_name": "FARRAR",
        "authorized_official_first_name": "HUNTER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "985-792-9001",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2206672",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coastal Pharmacy Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Coastal Pharmacy Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kevin Bryan Clement, M.D.
• John Clemmons, PHD
• Clayton W Clifton Jr., RPH
• Payton Engel Clinton, DC
• Ethan Clopton
• Jessica Elisabeth Coates
• Corvell Coburn, LCSW, RN
• Curtis W Cochran, NP
• Jennifer McDowell Cochran, MS CCC/SLP
• Leigh Ann Cochran, FNP-C

• Home Infusion Therapy Pharmacy in Hattiesburg, MS
• Providers in Hattiesburg, MS by specialty
• Home Infusion Therapy Pharmacy in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2020; 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.