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General NPI Number Information
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NPI Number | 1982523999
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Entity Type | Organization
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Legal Business Name | MENDOCINO COAST CLINICS, INC.
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Dates
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Enumeration Date | 07/13/2026
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Last Update Date | 07/13/2026
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Provider Practice Location Address
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Address Line | 350 CYPRESS ST
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City | FORT BRAGG
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State | CA
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Zip | 95437-5408
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Country | US
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Telephone | 707-964-1251
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Fax | 707-961-2722
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Provider Business Mailing Address
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Address Line | 205 SOUTH ST
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City | FORT BRAGG
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State | CA
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Zip | 95437-5540
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Country | US
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Telephone | 707-964-1251
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Fax | 707-961-2722
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | LUCRESHA M RENTERIA
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Credential |
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Telephone | 707-964-1251
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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 |
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License Number State |
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