Organization
COASTAL HOME CARE
Active
Other names
American HomePatient
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FRANK POWERS (CHIEF OPERATING OFFICER)
(615) 221-8149
Entity
Organization
Contact information
Practice address
4209 MAYFAIR ST, SUITE B, MYRTLE BEACH, SC 29577-5899
(843) 839-1649
(843) 839-1699
Mailing address
PO BOX 532549, ATLANTA, GA 30353-2549
(843) 821-8525
(843) 821-0982
Taxonomy
Speciality
Code
Description
License number
State
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
65-006981
SC
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
65-006981
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DME115
—
SC
Enumeration date
02/21/2006
Last updated
08/19/2010
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