# COASTAL HEALTHCARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Coastal Healthcare
- **Organization subpart:** No

## Provider details

- **NPI number:** 1700543071
- **Authorized official:** ASHLEY PETER NAGEL PHARMD (OWNER/AUTHORIZED OFFICIAL)
- **Authorized official phone:** (912) 441-5240

## Contact information

- **Practice address:** 204 BUTLER ST, MIDWAY, GA 31320-4596
- **Practice address phone:** (912) 884-9255
- **Practice address fax:** (912) 884-9257
- **Mailing address:** 204 BUTLER ST, MIDWAY, GA 31320-4596
- **Mailing address phone:** (912) 884-9255
- **Mailing address fax:** (912) 884-9257

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/22/2021
- **Last updated:** 11/22/2021