Healthcare Provider Details

I. General information

NPI: 1205975778
Provider Name (Legal Business Name): COATS PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 08/30/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

393 N MCKINLEY ST
COATS NC
27521-8132
US

IV. Provider business mailing address

PO BOX 811 393 N MCKINLEY ST
COATS NC
27521-0811
US

V. Phone/Fax

Practice location:
  • Phone: 910-897-8500
  • Fax: 910-897-5114
Mailing address:
  • Phone: 910-897-8500
  • Fax: 910-897-5114

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number09283
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number09283
License Number StateNC

VIII. Authorized Official

Name: MS. DIANA S LISCHIN
Title or Position: OWNER MANAGER PHARMACIST
Credential: RPH
Phone: 910-897-8500