COASTAL PHARMACY LLC (NPI# 1811140841) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811140841 |
| Entity Type | Organization |
| Organization Name | COASTAL PHARMACY LLC |
| Other Organization Name | COASTAL PHARMACY & WELLNESS |
| Practice Address |
29 Marginal Way Suite 4 Portland ME 04101-1914 |
| Practice Telephone | 2078990886 |
| Practice Fax Number | 2078990826 |
| Mailing Telephone | 2078990886 |
| Mailing Fax Number | 2078990826 |
| Enumeration Date | 2008-11-04 |
| Last Update Date | 2019-05-07 |
| Authorized Official Name | CASSI Q BROOKS (PRINCIPAL) |
| Authorized Official Telephone | 2078990886 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
Suppliers |
| Other Name | Type Code |
|---|---|
| Coastal Pharmacy & Wellness | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528267499 | Coastal Pharmacy LLC | Pharmacy | 504 Garden St, Titusville, FL 32796 | 2007-07-12 |
| 1831603430 | Coastal Pharmacy LLC | Pharmacy | 504 Garden St, Titusville, FL 32796-3405 | 2017-11-20 |
| Street Address |
29 MARGINAL WAY SUITE 4 |
| City | PORTLAND |
| State | ME |
| Zip Code | 04101-1914 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306450655 | Jocylin Egan | Nurse Practitioner | 442 Congress Street, 2nd Floor, Portland, ME 04101 | 2020-09-03 |
| 1255963559 | Portcity Home Healthcare LLC | In Home Supportive Care | 525 Forest Avenue, Suite 8, Portland, ME 04101 | 2020-02-05 |
| 1578101929 | Mohamed Hassan Mohamed | Student in an Organized Health Care Education/Training Program | 75 Lancaster St Ste 218a, Portland, ME 04101 | 2019-12-17 |
| 1841855301 | Portland Opioid Health Home | Counselor | 48 Free St., Mezzanine Level, Portland, ME 04101 | 2019-05-09 |
| 1093379224 | Alexandra Strawbridge Maurer | Acupuncturist | 50 A Cove Street, Portland, ME 04101 | 2019-04-23 |
| 1245719541 | Scott J Whited | Nurse Practitioner | 216 Vaughan St., Mcgeachy Hall, Portland, ME 04101 | 2018-08-08 |
| 1144733064 | Alixandria Elaine Marie Winchell | Massage Therapist | One City Center, Portland, ME 04101 | 2017-11-14 |
| 1417473638 | Rachel S Schwaner | Occupational Therapist | 78 Danforth Street, Apartment 6, Portland, ME 04101 | 2017-08-18 |
| 1023538154 | Derina Boothroyd | Audiologist-Hearing Aid Fitter | 985 Forest Ave., Portland, ME 04101 | 2017-06-20 |
| 1881123297 | Mark Mccullough | Social Worker | 57 Exchange Street, Suite 403, Portland, ME 04101 | 2017-06-08 |
| Find all providers in zip 04101 | ||||
| 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 |
|---|---|---|---|---|
| 1528545969 | Willamette Pharmacy | Pharmacy | 10209 Se Division Build B Ste 100, Portland, OR 97266 | 2018-07-27 |
| 1922536606 | Pharmacy Acquisition Co., LLC | Pharmacy | 1286 Se Holgate Blvd # C-2, Portland, OR 97202-5053 | 2017-05-25 |
| 1639232929 | Pharmaca Integrative Pharmacy, Inc. | Pharmacy | 13 Nw 23rd Pl, Portland, OR 97210 | 2006-12-18 |
| 1891755799 | Stroheckers Pharmacy Inc | Pharmacy | 1286 Se Holgate Blvd, Suite C-1, Portland, OR 97202-5053 | 2006-03-24 |
| 1225078223 | Kaiser Foundation Health Plan of The Northwest | Pharmacy | 5717 Ne 138th Ave, Portland, OR 97230-3409 | 2006-06-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942830922 | Classic Compounding Pharmacy, LLC | Pharmacy | 1171 Us Route 1, York, ME 03909-5837 | 2020-01-18 |
| 1275520686 | Community Pharmacies LLC | Pharmacy | 244 Main St, Saco, ME 04072-1509 | 2005-09-30 |
| 1811255318 | South Berwick Pharmacy Seacoast Compounding Inc. | Pharmacy | 289 Main St, South Berwick, ME 03908-1543 | 2012-05-03 |
| 1225328669 | Moby Rx | Pharmacy | 225 Waterman Dr, South Portland, ME 04106-3634 | 2011-04-19 |
| 1144201377 | West End Drug Company | Pharmacy | 105 Main St, Bar Harbor, ME 04609-1844 | 2005-11-05 |
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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.