# COASTAL LIFE AMBULANCE, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Eastbound & Down, Inc.
- **Organization subpart:** No

## Provider details

- **NPI number:** 1891126652
- **Authorized official:** MR. JAMES CLAIR BRUSSEAU II (PRESIDENT)
- **Authorized official phone:** (916) 871-8487

## Contact information

- **Practice address:** 415 ROBERTSON BLVD STE B, WALTERBORO, SC 29488-5713
- **Practice address phone:** (888) 935-5525
- **Mailing address:** PO BOX 487, WALTERBORO, SC 29488-0005
- **Mailing address phone:** (888) 935-5525

## Taxonomy

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

## Other

- **Enumeration date:** 12/04/2013
- **Last updated:** 05/04/2014