# UNITED STATED COAST GUARD

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023296597
- **Authorized official:** MRS. DANA MARIE PENDARVIS (CORPSMAN)
- **Authorized official phone:** (508) 968-6703

## Contact information

- **Practice address:** 5201 LEE RD, BUZZARDS BAY, MA 02542-1313
- **Practice address phone:** (508) 968-6703
- **Mailing address:** 5201 LEE RD, BUZZARDS BAY, MA 02542-1313
- **Mailing address phone:** (508) 968-6703

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 02/06/2008
- **Last updated:** 02/06/2008