Organization
COASTAL COMMUNITY HEALTH SERVICES, INC.
Active
Other names
Coastal Community Health-Jacksonville
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KAVANAUGH CHANDLER MD (CEO)
(912) 275-8028
Entity
Organization
Contact information
Practice address
1605 KINGSLEY AVE, ORANGE PARK, FL 32073-4435
(904) 750-3380
Mailing address
100 PROFESSIONAL CENTER DR, BRUNSWICK, GA 31525-6743
(912) 574-5075
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
12/02/2024
Last updated
05/14/2025
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