# USCG

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

## Provider details

- **NPI number:** 1205957982
- **Authorized official:** WYATT HELLEY (HEALTH SERVICE TECHNICAN 3 CLASS)
- **Authorized official phone:** (508) 968-6704

## Contact information

- **Practice address:** 5439 A LEMAY AVE., BUZZARDS BAY, MA 02542
- **Practice address phone:** (508) 968-6704
- **Mailing address:** 5403 A LEMAY AVE., BUZZARDS BAY, MA 02542

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1100X | Military/U.S. Coast Guard Outpatient Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 04/02/2007
- **Last updated:** 08/22/2020