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Organization
COASTAL HOME CARE
Active
Organization
COASTAL HOME CARE
Active
Other names
American HomePatient
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FRANK POWERS (CHIEF OPERATING OFFICER)
(615) 221-8149
Entity
Organization
Contact information
Practice address
4209 MAYFAIR ST, SUITE B, MYRTLE BEACH, SC 29577-5899
(843) 839-1649
(843) 839-1699
Mailing address
PO BOX 532549, ATLANTA, GA 30353-2549
(843) 821-8525
(843) 821-0982
Taxonomy
Speciality
Code
Description
License number
State
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
65-006981
SC
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
65-006981
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DME115
—
SC
Enumeration date
02/21/2006
Last updated
08/19/2010
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