NPIMap

Organization Active NPI

Coastal Care Pharmacy Inc

Doing business as Medical Park Pharmacy West

  • Specialty Pharmacy
  • Morehead City, NC
National Provider Identifier
1972894145
Registry record updated Apr 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Specialty PharmacyTaxonomy code 3336S0011X
License
8384 Issued in NC
Legal business name
COASTAL CARE PHARMACY INC
Doing business as
Medical Park Pharmacy West
Practice address
278 Hwy 24
Suite M
Morehead City, NC 28557-2582
Phone
(252) 726-0279
Fax
(252) 726-0792
NPI assigned
Apr 22, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2011

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

Authorized official

Name
Fletcher JohnstonNPI 1053601948
Title
President
Phone
(252) 726-0279

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialty Pharmacy 3336S0011X 8384 NC Primary

Addresses

Primary practice location

278 Hwy 24
Suite M
Morehead City, NC 28557-2582

Mailing address

278 Hwy 24
Suite M
Morehead City, NC 28557-2582
Phone (252) 726-0279

Other identifiers 1

IdentifierTypeStateIssuer
0165422MedicaidNC

Other names 1

  • Medical Park Pharmacy West Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Coastal Care Pharmacy Inc2 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.

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1303430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303430400000",
    "number": "1972894145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "278 HWY 24",
            "address_2": "SUITE M",
            "city": "MOREHEAD CITY",
            "state": "NC",
            "postal_code": "285572582",
            "telephone_number": "252-726-0279",
            "fax_number": "252-726-0792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "278 HWY 24",
            "address_2": "SUITE M",
            "city": "MOREHEAD CITY",
            "state": "NC",
            "postal_code": "285572582",
            "telephone_number": "252-726-0279",
            "fax_number": "252-726-0792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL CARE PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-22",
        "last_updated": "2011-04-22",
        "status": "A",
        "authorized_official_last_name": "JOHNSTON",
        "authorized_official_first_name": "FLETCHER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "252-726-0279"
    },
    "taxonomies": [
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "NC",
            "license": "8384",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0165422",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medical Park Pharmacy West",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Morehead City, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2011; 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.