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 1114124864

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

1075 Smith St 2nd Fl
Providence, RI 02908-2700
Phone: (401) 421-4400
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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 MD08852 (RI)

Record details

NPI number1114124864
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationMedvantx, Inc
Authorized official Kenny Heine — Vp Of Operations · (858) 625-2990
Other names Coastal Medical - Elmhurst
NPI enumeratedJune 27, 2007
Last updated in NPPESOctober 24, 2013
Mailing address5626 Oberlin Dr, Suite 110, San Diego, CA 92121-1705

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