1346913530 NPI number — NORTH COAST MEDICAL SUPPLY, LLC

Table of content: (NPI 1346913530)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346913530 NPI number — NORTH COAST MEDICAL SUPPLY, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NORTH COAST MEDICAL SUPPLY, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1346913530
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/01/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 9041
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CARLSBAD
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92018-9041
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-730-9887
Provider Business Mailing Address Fax Number:
800-503-6280

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2544 CAMPBELL PL STE 150
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CARLSBAD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92009-1768
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-730-9887
Provider Business Practice Location Address Fax Number:
800-503-6280
Provider Enumeration Date:
07/26/2021

Additional Information

Authorized Official

Authorized Official Last Name:
ALVAREZ
Authorized Official First Name:
ANTHONY
Authorized Official Middle Name:
Authorized Official Title or Position:
SVP CUSTOMER OPERATIONS
Authorized Official Telephone Number:
800-321-0591

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 5601690 . This is a "NCPDP PROVIDER IDENTIFICATION NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: PHA466150 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




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