Organization
COASTAL MED TECH INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON E SEVEY (COMPLIANCE OFFICER)
(207) 848-7152
Entity
Organization
Contact information
Practice address
364 STATE ST, BANGOR, ME 04401-6604
(207) 848-7730
(207) 848-7767
Mailing address
364 STATE STREET, BANGOR, ME 04401
(207) 848-7730
(207) 848-7767
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
11886000
ME
Other
Enumeration date
04/23/2012
Last updated
01/10/2017
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