Active NPI
Coastal Pharmacies, LLC
- Pharmacy
- Waldport, OR
National Provider Identifier
1992863286
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- License
- RP0001011CS
- Legal business name
- COASTAL PHARMACIES, LLC
- Practice address
- 110 SW Highway 101
Waldport, OR 97394-3035 - Phone
- (541) 563-4848
- Fax
- (541) 563-4747
- NPI assigned
- Dec 5, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kristi Veis
- Title
- VP of Pharmacy
- Phone
- (503) 507-6073
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | RP0001011CS | OR | Primary |
Addresses
Primary practice location
110 SW Highway 101
Waldport, OR 97394-3035
Mailing address
916 W Evergreen Blvd
Vancouver, WA 98660-3035
Phone (360) 213-2236
Other practice location 1
110 SW Arrow St
Waldport, OR 97394-3032
Phone (541) 563-4848
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3813424 | Other | NCPDP PROVIDER IDENTIFICATION NUMBER |
Other names 1
- Waldport Drug and Gift #1187
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20041102001236 | OR | Part B Supplier - Mass Immunization (Roster Biller Only) | 9234191149 |
7 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Corvallis, OR; Lebanon, OR; Silverton, OR; Sisters, OR |
| O20121019000672 | OR | Part B Supplier - Mass Immunization (Roster Biller Only) | 5294985602 |
1 other NPI on this enrollment Practice locations: Waldport, OR |
Other NPIs on the same Medicare enrollment 5
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider Directory- Tax ID family
- Coastal Pharmacies LLC
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Pharmacy
- Waldport, OR
- NPI 1093144248
-
- Pharmacy
- Cave Junction, OR
- NPI 1366871519
Locations
24991 Highway 126
Veneta, OR 97487
Phone (541) 935-2201
180 NW Highway 101
#1187
Waldport, OR 97394
Phone (541) 563-4848
110 SW Highway 101
Waldport, OR 97394
Phone (541) 563-4848
Practitioners & affiliated clinicians
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pharmacist
- Newport, OR
- NPI 1114379393
-
- Pharmacist
- Veneta, OR
- NPI 1821424987
-
- Pharmacist
- Veneta, OR
- NPI 1972613792
-
- Pharmacist
- Brewster, WA
- NPI 1427773951
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165276800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1734393600000",
"number": "1992863286",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "916 W EVERGREEN BLVD",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986603035",
"telephone_number": "360-213-2236",
"fax_number": "360-213-2238"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 SW HIGHWAY 101",
"city": "WALDPORT",
"state": "OR",
"postal_code": "973943035",
"telephone_number": "541-563-4848",
"fax_number": "541-563-4747"
}
],
"practiceLocations": [
{
"address_1": "110 SW Arrow St",
"address_purpose": "LOCATION",
"city": "Waldport",
"state": "OR",
"postal_code": "973943032",
"country_code": "US",
"telephone_number": "541-563-4848",
"fax_number": "541-563-4747",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "COASTAL PHARMACIES, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-12-05",
"last_updated": "2024-12-17",
"certification_date": "2024-12-17",
"status": "A",
"authorized_official_last_name": "VEIS",
"authorized_official_first_name": "KRISTI",
"authorized_official_title_or_position": "VP OF PHARMACY",
"authorized_official_telephone_number": "503-507-6073"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "OR",
"license": "RP0001011CS",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
"identifier": "3813424",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Waldport Drug and Gift #1187",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Waldport Drug and Gift #1187",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Waldport, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.