Organization
COASTAL MED TECH, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHANNON SEVEY (COMPLIANCE OFFICER)
(207) 848-7152
Entity
Organization
Contact information
Practice address
210 COLLEGE AVE, WATERVILLE, ME 04901
(207) 872-7351
(207) 872-7310
Mailing address
210 COLLEGE AVE., WATERVILLE, ME 04901
(207) 872-7351
(207) 872-7310
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
1142511
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
118860000
—
ME
Enumeration date
03/01/2007
Last updated
10/13/2016
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