Southern Cancer Center, PC

Primary specialty

PharmacyTaxonomy code 333600000X

Legal business name

SOUTHERN CANCER CENTER, PC

Doing business as

Coastal Pharmacy Providence

Practice address

6701 Airport Blvd.
'B' BLDG., 'T' Level
Mobile, AL 36608-3764

Phone

(251) 607-5061

NPI assigned

Oct 4, 2023

Last updated

Oct 4, 2023By 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 names 1

• Coastal Pharmacy Providence Doing business as

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 LLC

  • Pharmacy
  • Daphne, AL
  • NPI 1619215381
  NPD tax ID

Locations

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

{
    "created_epoch": "1696377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696377600000",
    "number": "1962282178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "SOUTHERN CANCER CENTER, PC DBA COASTAL PHARM PROVIDENCE",
            "address_2": "29653 ANCHOR CROSS BLVD.",
            "city": "DAPHNE",
            "state": "AL",
            "postal_code": "365269594",
            "telephone_number": "251-607-5061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6701 AIRPORT BLVD.",
            "address_2": "'B' BLDG., 'T' LEVEL",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366083764",
            "telephone_number": "251-607-5061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN CANCER CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-04",
        "last_updated": "2023-10-04",
        "certification_date": "2023-10-02",
        "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": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coastal Pharmacy Providence",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Southeast Joint Replacement, LLC
• Southeastern Surgical Specialist, P.C.
• Southern Behavioral Health LLC
• Southern Cancer Center, PC (Coastal Pharmacy Springhill)
• Southern Cancer Center, PC
• Southern Cross Home Care of Al, LLC
• Southern Family Markets LLC (Bruno's Food and Pharmacy)
• Southern Medical & Mobility Inc
• Southern Medical Foundation
• Southern Orthopaedic Alliance PLLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2023; 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.