# COASTAL CAROLINA HEART, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** WILMINGTON HEART CENTER
- **Organization subpart:** No

## Provider details

- **NPI number:** 1932298668
- **Authorized official:** MR. GARY GUIDRY (CEO)
- **Authorized official phone:** (704) 815-7804

## Contact information

- **Practice address:** 1604 PHYSICIANS DR, SUITE 104, WILMINGTON, NC 28401-7362
- **Practice address phone:** (910) 762-2292
- **Practice address fax:** (910) 762-2208
- **Mailing address:** 10720 SIKES PL, SUITE 300, CHARLOTTE, NC 28277-8141
- **Mailing address phone:** (704) 815-7789
- **Mailing address fax:** (888) 401-6931

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 10/12/2006
- **Last updated:** 08/07/2009