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Organization

COASTAL MED TECH INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. SHANNON E SEVEY (COMPLIANCE OFFICER)
(207) 848-8330
Entity
Organization

Contact information

Practice address
844 US ROUTE 2 E, WILTON, ME 04294-3864
(207) 645-3343
(207) 645-3338
Mailing address
844 US ROUTE 2 E, WILTON, ME 04294-3864
(207) 645-3343
(207) 645-3338

Taxonomy

Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
1145929
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
118860000
ME
Enumeration date
05/01/2012
Last updated
10/05/2016
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