Organization
COASTAL COMPREHENSIVE CARE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TERRESA A LONG NP (PRESIDENT)
(910) 663-2273
Entity
Organization
Contact information
Practice address
710 SUNSET BLVD N STE A, SUNSET BEACH, NC 28468-4340
(910) 663-2273
(910) 663-4050
Mailing address
PO BOX 2123, BRYSON CITY, NC 28713-5123
(910) 490-0490
(828) 538-4441
Taxonomy
Speciality
Code
Description
License number
State
207LA0401X
Addiction Medicine (Anesthesiology) Physician
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02EYB
BCBS NC
NC
05
—
1457828253
—
NC
01
—
EC2848
RAILROAD MEDICARE
NC
01
—
I564
MEDICARE
NC
Enumeration date
10/30/2018
Last updated
01/30/2025
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