# COASTLINE AMBULANCE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Coastline Ambulance LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275320855
- **Authorized official:** MR. BRENT MATTHEW JOHNS PARAMEDIC (CO-OWNER)
- **Authorized official phone:** (843) 356-2326

## Contact information

- **Practice address:** 1400 CHURCH ST STE 300B, CONWAY, SC 29526-4159
- **Practice address phone:** (843) 712-5767
- **Mailing address:** PO BOX 478, CONWAY, SC 29528-0478
- **Mailing address phone:** (843) 712-5767

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | — | NULL | Yes |

## Other

- **Enumeration date:** 04/24/2025
- **Last updated:** 05/05/2025