Provider Demographics
NPI:1891487138
Name:COASSIST PHARMACY, LLC
Entity Type:Organization
Organization Name:COASSIST PHARMACY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:ALWYN
Authorized Official - Middle Name:
Authorized Official - Last Name:MARS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-641-3033
Mailing Address - Street 1:2400 SAND LAKE RD STE 200A
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32809-7662
Mailing Address - Country:US
Mailing Address - Phone:407-641-3033
Mailing Address - Fax:
Practice Address - Street 1:2400 SAND LAKE RD STE 200A
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32809-7662
Practice Address - Country:US
Practice Address - Phone:407-641-3033
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ASSISTRX, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-05-24
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy