Provider Demographics
NPI:1467823799
Name:SUNCOAST PHARMACY, INC.
Entity Type:Organization
Organization Name:SUNCOAST PHARMACY, INC.
Other - Org Name:SUNCOAST PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GOPAL
Authorized Official - Middle Name:
Authorized Official - Last Name:NAVANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-543-7185
Mailing Address - Street 1:18354 BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92648-1311
Mailing Address - Country:US
Mailing Address - Phone:714-848-0700
Mailing Address - Fax:
Practice Address - Street 1:18354 BEACH BLVD
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92648-1311
Practice Address - Country:US
Practice Address - Phone:714-848-0700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-13
Last Update Date:2015-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0004X
CA537703336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy