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General NPI Number Information
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NPI Number | 1134583305
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Entity Type | Organization
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Legal Business Name | COASTAL FAMILY HEALTH CENTER INC
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Dates
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Enumeration Date | 04/13/2016
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Last Update Date | 11/11/2025
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Provider Practice Location Address
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Address Line | 9113 HIGHWAY 49 STE 200
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City | GULFPORT
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State | MS
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Zip | 39503-4330
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Country | US
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Telephone | 228-374-2494
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Fax | 228-374-2713
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Provider Business Mailing Address
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Address Line | 10467 CORPORATE DR
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City | GULFPORT
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State | MS
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Zip | 39503-4634
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Country | US
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Telephone | 228-374-2494
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Fax | 228-374-2713
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE
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Name | RHONDA DUNAWAY
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Credential |
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Telephone | 288-374-2494
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | CS14729
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License Number State | MS
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