Provider Demographics
NPI:1942741491
Name:COASTAL PHARMACEUTICA SERVICES CORP
Entity Type:Organization
Organization Name:COASTAL PHARMACEUTICA SERVICES CORP
Other - Org Name:HERBAY PHARMACY NORTH/INFUSIONRX
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:MAY
Authorized Official - Middle Name:KUO
Authorized Official - Last Name:BARRY
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:805-981-2500
Mailing Address - Street 1:1451 N RICE AVE
Mailing Address - Street 2:SUITE F
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93030-7926
Mailing Address - Country:US
Mailing Address - Phone:805-981-2500
Mailing Address - Fax:805-981-8447
Practice Address - Street 1:1451 N RICE AVE
Practice Address - Street 2:SUITE F
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93030-7926
Practice Address - Country:US
Practice Address - Phone:805-981-2500
Practice Address - Fax:805-981-8447
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PHARMERICA CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-03-16
Last Update Date:2017-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHA454453336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy