# COASTAL MED-TECH CORP.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Quipt Home Medical Ellsworth
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639647324
- **Authorized official:** GREG CRAWFORD (PRESIDENT)
- **Authorized official phone:** (859) 441-8876

## Contact information

- **Practice address:** 177 COLLEGE AVE, WATERVILLE, ME 04901-6219
- **Practice address phone:** (800) 773-6511
- **Practice address fax:** (207) 872-7310
- **Mailing address:** 1019 TOWN DR, HIGHLAND HEIGHTS, KY 41076-9114
- **Mailing address phone:** (859) 441-8876
- **Mailing address fax:** (859) 441-5850

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 332BX2000X | Oxygen Equipment & Supplies (DME) | — | NULL | Yes |

## Other

- **Enumeration date:** 11/12/2018
- **Last updated:** 03/26/2024