Organization
COASTAL CAROLINA PATHOLOGY, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHRYN J LAIRD (OFFICE ADMINISTRATOR)
(910) 395-4441
Entity
Organization
Contact information
Practice address
2606 IRON GATE DR, SUITE 201, WILMINGTON, NC 28412-2573
(910) 395-4441
(910) 395-7074
Mailing address
2606 IRON GATE DR, SUITE 201, WILMINGTON, NC 28412-2494
(910) 395-4441
(910) 395-7074
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
014KU
BCBS
NC
01
—
690009530
RAILROAD MEDICARE
—
05
—
7001210
—
NC
Enumeration date
03/16/2006
Last updated
07/10/2013
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