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General NPI Number Information
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NPI Number | 1386885515
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Entity Type | Organization
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Legal Business Name | EAST COAST PHARMACY LLC
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Dates
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Enumeration Date | 03/18/2009
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Last Update Date | 07/19/2018
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Provider Practice Location Address
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Address Line | 695 N WASHINGTON AVE UNIT 101
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City | TITUSVILLE
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State | FL
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Zip | 32796-2101
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Country | US
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Telephone | 321-747-0600
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Fax | 321-385-2180
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Provider Business Mailing Address
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Address Line | 695 N WASHINGTON AVE UNIT 101
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City | TITUSVILLE
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State | FL
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Zip | 32796-2101
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Country | US
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Telephone | 321-747-0600
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Fax | 321-385-2180
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Authorized Official
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Title or Position | OWNER/MANAGER/AO
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Name | NITIN AGGARWAL
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Credential |
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Telephone | 352-213-4295
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PH24139
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License Number State | FL
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