Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Coastal Medical, Inc

Organization Non-Pharmacy Dispensing Site · NPI 1073655379

Coastal Medical, Inc is a Non-Pharmacy Dispensing Site in Providence, Rhode Island. Licensed in Rhode Island. Registered with an NPI since 2007.

Licensed in
RI
In the registry since
2007
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

400 Reservoir Ave
Providence, RI 02907-3565
Phone: (401) 781-2400
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Non-Pharmacy Dispensing Site (primary) Taxonomy 332900000X · Licence MD13369 (RI)

Record details

NPI number1073655379
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationMedvantx, Inc
Authorized official Kenny Heine — Vp Of Operations · (858) 625-2990
NPI enumeratedFebruary 13, 2007
Last updated in NPPESNovember 7, 2014
Mailing address5626 Oberlin Dr, Suite 110, San Diego, CA 92121-1705

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