# COAST 2 COAST MEDICAL LLC

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

## Provider details

- **NPI number:** 1235776188
- **Authorized official:** PATRICK S COURTNEY (OWNER)
- **Authorized official phone:** (720) 581-4607

## Contact information

- **Practice address:** 2637 JUPITER WAY, THE VILLAGES, FL 32163-6334
- **Practice address phone:** (720) 581-4607
- **Practice address fax:** (888) 373-0502
- **Mailing address:** 2637 JUPITER WAY, THE VILLAGES, FL 32163-6334
- **Mailing address phone:** (720) 581-4607
- **Mailing address fax:** (888) 373-0502

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | Yes |

## Other

- **Enumeration date:** 12/10/2019
- **Last updated:** 12/10/2019