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COASTAL MEDICAL, INC.
NPI 1073655379
Non-Pharmacy Dispensing Site in Providence, RI

Active since February 13, 2007
400 RESERVOIR AVE, PROVIDENCE, RI 02907(401) 781-2400 Get Directions Write a Review

NPPES record last updated: November 7, 2014. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Coastal Medical, Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

COASTAL MEDICAL, INC. (NPI 1073655379) is a healthcare organization registered as a non-pharmacy dispensing site in Providence, Rhode Island and active in the NPI registry since February 2007. The organization lists Kenny Heine, Vp Of Operations, as its authorized official.

NPPES Registry Identity

NPI1073655379
Entity TypeOrganization
Primary Taxonomy332900000X
Legal Business NameCOASTAL MEDICAL, INC.
Location Address400 RESERVOIR AVEProvidence, RI 02907-3565
Mailing Address5626 Oberlin Dr, Suite 110San Diego, CA 92121-1705 · (858) 625-2990
Phone(401) 781-2400
Organization SubpartYesParent: Medvantx, Inc.
Authorized OfficialKenny HeineVp Of Operations · (858) 625-2990
Enumeration DateFebruary 13, 2007
Last NPPES UpdateNovember 7, 2014
✔ NPI 1073655379 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNon-Pharmacy Dispensing SiteSuppliers
Taxonomy Code332900000X
License✔ Licensed in RI · MD13369
Definition
A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)
400 RESERVOIR AVE, Providence, RI 02907
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Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

THE WELLNESS CENTER RI, LLC
Community/Behavioral Health
400 RESERVOIR AVE, SUITE 2K
PROVIDENCE, RI 02907
Providence County (401) 461-9355
DR. MICHAEL C FURIA DMD
Dentist (General Practice)
400 RESERVOIR AVE, SUITE 1D
PROVIDENCE, RI 02907
Providence County (401) 941-3353
DR. KATHLEEN MARY MELBOURNE PHARM.D.
Pharmacist (Pharmacotherapy)
400 RESERVOIR AVE, SUITE 1D COASTAL MEDICAL
PROVIDENCE, RI 02907
Providence County (401) 781-2400
DR. DAVID ANTHONY PEZZULLO DMD
Dentist (Periodontics)
400 RESERVOIR AVE, SUITE 3E
PROVIDENCE, RI 02907
Providence County (401) 781-3393

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Coastal Medical, Inc.'s NPI number?

The NPI number for Coastal Medical, Inc. is 1073655379. It was assigned to this organization in the NPPES registry on February 13, 2007.

Where is Coastal Medical, Inc. located?

Coastal Medical, Inc. is located at 400 Reservoir Ave, Providence, RI 02907. The listed phone number is (401) 781-2400.

What is Coastal Medical, Inc.'s specialty?

The primary specialty registered for this NPI is Non-Pharmacy Dispensing Site with taxonomy code 332900000X.

When was this NPI record last updated?

The NPPES record for Coastal Medical, Inc. was last updated on November 7, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.