Healthcare Provider Details

I. General information

NPI: 1245259282
Provider Name (Legal Business Name): NORTH COAST MEDICAL SUPPLY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2544 CAMPBELL PL STE 150
CARLSBAD CA
92009-1768
US

IV. Provider business mailing address

PO BOX 9041
CARLSBAD CA
92018-9041
US

V. Phone/Fax

Practice location:
  • Phone: 800-730-9887
  • Fax: 800-503-6280
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License NumberPHY46615
License Number StateCA

VIII. Authorized Official

Name: ANTHONY ALVAREZ
Title or Position: SVP CUSTOMER OPERATIONS
Credential:
Phone: 800-321-0591