Organization
COASTAL PLAINS HOME HEALTH AGENCY 9A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MITCHELL ADCOCK CPA CIA CFE (DIRECTOR OF FINANCE ADMINISTRATION)
(601) 576-7853
Entity
Organization
Contact information
Practice address
1102 45TH AVE, GULFPORT, MS 39501-2504
(228) 867-6115
(228) 867-6185
Mailing address
1102 45TH AVE, GULFPORT, MS 39501-2504
(228) 867-6115
(228) 867-6185
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
3481
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00070500
—
MS
Enumeration date
12/14/2005
Last updated
08/22/2020
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