Healthcare Provider Details

I. General information

NPI: 1437783495
Provider Name (Legal Business Name): COASTAL CARE PHARMACY - ALABASTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2020
Last Update Date: 02/28/2020
Certification Date: 02/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7895 HIGHWAY 119 STE 6
ALABASTER AL
35007-7554
US

IV. Provider business mailing address

7895 HIGHWAY 119 STE 6
ALABASTER AL
35007-7554
US

V. Phone/Fax

Practice location:
  • Phone: 205-621-8407
  • Fax: 866-257-3482
Mailing address:
  • Phone: 205-621-8407
  • Fax: 866-257-3482

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: CHARLES JOSEPH SHIRLEY
Title or Position: EXECUTIVE VICE PRESIDENT
Credential:
Phone: 205-246-2491