Organization
COASTAL MEDICAL SUPPLY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN W ROBERTS (OWNER)
(850) 250-0887
Entity
Organization
Contact information
Practice address
156 N COUNTY HIGHWAY 393, SANTA ROSA BEACH, FL 32459-5349
(850) 250-0887
Mailing address
156 N COUNTY HIGHWAY 393, SANTA ROSA BEACH, FL 32459-5349
(850) 250-0887
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
02/04/2015
Last updated
02/04/2015
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