# COASTAL ANESTHESIA ASSOCIATES, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1942252176
- **Authorized official:** DR. RANDALL E KERNS M.D. (OWNER)
- **Authorized official phone:** (843) 442-2486

## Contact information

- **Practice address:** 14 BROUGHTON RD, CHARLESTON, SC 29407-7529
- **Practice address phone:** (843) 553-7070
- **Practice address fax:** (843) 553-2223
- **Mailing address:** PO BOX 1465, LADSON, SC 29456-1465
- **Mailing address phone:** (843) 553-7070
- **Mailing address fax:** (843) 553-2223

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | — | NULL | Yes |
| 207L00000X | Anesthesiology Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/16/2006
- **Last updated:** 07/20/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | CJ4348 | RR MEDICARE | SC |
| 05 | — | GP3306 | — | SC |