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Organization

COASTAL THERAPEUTICS, INC

Active
Parent organization
COASTAL THERAPEUTICS
Other names
Coastal Therapeutics
Organization subpart
Yes

Provider details

NPI number
Legal business name
COASTAL THERAPEUTICS
Authorized official
MRS. STARLA KAY SULLIVAN (OWNER)
(251) 633-6235
Entity
Organization

Contact information

Practice address
28260 US HIGHWAY 98, DAPHNE, AL 36526-7075
(251) 626-5691
Mailing address
28260 US HIGHWAY 98, STE 4, DAPHNE, AL 36526-7075
(251) 626-5691

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00935005
AL
01
51511102
BCBS
AL
Enumeration date
11/19/2014
Last updated
12/11/2023
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