# COASTAL MED TECH INC

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

## Provider details

- **NPI number:** 1992063440
- **Authorized official:** SHANNON E SEVEY (COMPLIANCE OFFICER)
- **Authorized official phone:** (207) 848-7152

## Contact information

- **Practice address:** 376 NORTH MAINE STREET, SUITE C, CALAIS, ME 04619
- **Practice address phone:** (207) 454-0402
- **Practice address fax:** (207) 454-0421
- **Mailing address:** 376 NORTH STREETSUITE C, CALAIS, ME 04619
- **Mailing address phone:** (207) 454-0402
- **Mailing address fax:** (207) 454-0421

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332BX2000X | Oxygen Equipment & Supplies (DME) | 11886000 | ME | Yes |

## Other

- **Enumeration date:** 05/02/2012
- **Last updated:** 01/10/2017