COASTAL PHARMACY LABS LLC (NPI# 1477718385) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477718385 |
| Entity Type | Organization |
| Organization Name | COASTAL PHARMACY LABS LLC |
| Other Organization Name | COASTAL COMPOUNDING PHARMACY |
| Practice Address |
6709 Forest Park Dr Ste A Savannah GA 31406-2587 |
| Practice Telephone | 9123545188 |
| Practice Fax Number | 9123553685 |
| Mailing Telephone | 9123545188 |
| Mailing Fax Number | 9123553685 |
| Enumeration Date | 2008-07-21 |
| Last Update Date | 2013-09-23 |
| Authorized Official Name | AL DIXON (OWNER) |
| Authorized Official Telephone | 9127563331 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
PHRE009634 | GA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2141985 | 01 |
| Other Name | Type Code |
|---|---|
| Coastal Compounding Pharmacy | Doing Business As Name - Organization |
| Street Address |
6709 FOREST PARK DR STE A |
| City | SAVANNAH |
| State | GA |
| Zip Code | 31406-2587 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891324042 | Magnolia Home Health, LLC Dba Home Instead Senior Care | Homemaker | 6709 Forest Park Drive, Suite B, Savannah, GA 31406 | 2020-04-08 |
| 1831737949 | Sumona Mitchell | Specialist | 1100 Eisenhower Drive 15, Suite 7, Savannah, GA 31406 | 2019-12-19 |
| 1295373090 | Gateway Behavioral Health Services | Community/Behavioral Health | 2121 East Derenne Ave, Savannah, GA 31406 | 2019-12-12 |
| 1114578820 | Kenya Burns | Technician | 6 Castle Ct, Savannah, GA 31406 | 2019-09-24 |
| 1841755287 | Southside Emergency Dental Center LLC | Dentist | 10515 White Bluff Rd., Savannah, GA 31406 | 2019-02-08 |
| 1639651003 | Rachael Putman | Physical Therapist | 37 W Fairmont Ave Suite 323, Savannah, GA 31406 | 2018-09-03 |
| 1417439852 | Happy Kids Therapies, LLC | Physical Therapist | 37 W. Fairmont Avenue Suite 102, Savannah, GA 31406 | 2018-09-01 |
| 1487146619 | Georgia Occmed LLC | Clinic/Center | 310 Eisenhower Dr Bldg 12 Ste C, Savannah, GA 31406 | 2018-06-04 |
| 1023517505 | Antioch Vascular Center, LLC | Surgery | 9104 Middleground Road, Suite 2, Savannah, GA 31406 | 2018-02-09 |
| 1518496116 | Janay C Russell | Counselor | 6711 Forest Park Drive, Savannah, GA 31406 | 2017-06-07 |
| Find all providers in zip 31406 | ||||
| Taxonomy Code | 3336C0004X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Compounding Pharmacy |
| A pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner’s Prescription Drug Order or initiative based on the Practitioner/Patient/Pharmacist relationship in the course of professional practice. A compounding pharmacy utilizes specialized equipment and specially designed facilities necessary to meet the legal and quality requirements of its scope of compounding practice. |
| Notes: Sources: NABP Model Practice Act, Appendix C - Good Compounding Practice, USP <795> and <797>, and Pharmacy Compounding Accreditation Board [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629438296 | Express Drugs of Savannah LLC | Pharmacy | 824 E De Renne Ave, Savannah, GA 31405-6717 | 2016-02-25 |
| 1275908113 | Shiv Pharmacy Inc | Pharmacy | 718 Martin Luther King Jr Blvd Ste A, Savannah, GA 31401-5570 | 2015-12-03 |
| 1467783209 | Southeastern Medical Compounding LLC | Pharmacy | 709 Mall Blvd Rm 356b, Savannah, GA 31406-4805 | 2010-01-19 |
| 1578714515 | Compounding Solutions of Savannah, LLC | Pharmacy | 603 E 69th St, Savannah, GA 31405 | 2008-10-08 |
| 1912024381 | Iv Specialists Inc | Pharmacy | 24 Commerce Pl, Ste D, Savannah, GA 31406-3699 | 2007-03-23 |
| 1851478978 | Quick Rx Drugs Inc | Pharmacy | 911 E 65th Street, Savannah, GA 31405 | 2006-11-01 |
| 1316918436 | Optum Infusion Services 209, Inc. | Pharmacy | 1000 Business Center Drive Ste 120, Savannah, GA 31405 | 2006-01-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982204921 | P2 Pharmaceutical Services, LLC | Pharmacy | 2744 Broad St, Austell, GA 30106-3200 | 2020-10-28 |
| 1326654179 | Hawthorne Compounding Pharmacy LLC | Pharmacy | 100 Hawthorne Ln Ste A, Athens, GA 30606-2171 | 2020-09-17 |
| 1730710914 | Servemed, Inc | Pharmacy | 10263 Us Hwy 19, Suite 226, 226 Plaza Drive, Zebulon, GA 30295 | 2020-01-28 |
| 1013471010 | Kennison Pharmacy, LLC | Pharmacy | 4050 Buford Drive, Buford, GA 30518 | 2019-01-24 |
| 1629563317 | Dalton Worx, LLC | Pharmacy | 1506 N Thornton Ave Ste A, Dalton, GA 30720-8515 | 2018-06-26 |
| 1285145789 | Express At Northside LLC | Pharmacy | 296 Northside Dr Sw, Atlanta, GA 30313-1228 | 2017-10-24 |
| 1619411394 | Rita Rx Inc | Pharmacy | 3379 Highway 5 Ste F, Douglasville, GA 30135-2377 | 2016-12-14 |
| 1942756176 | Med-4-you LLC | Pharmacy | 3970 Peachtree Industrial Blvd, Berkeley Lake, GA 30096-4809 | 2016-08-28 |
| 1245785120 | Lambert Pharmacy LLC | Pharmacy | 15 Thomas Grace Annex Ln Ste 150, Sharpsburg, GA 30277-3653 | 2016-08-19 |
| 1588021430 | C & G Pharmacy LLC | Pharmacy | 11940 Alpharetta Hwy Ste 106, Alpharetta, GA 30009-2004 | 2016-01-23 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.