Organization
COASTAL COMMUNITY HEALTH SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KAVANAUGH CHANDLER MD (CEO)
(912) 275-8028
Entity
Organization
Contact information
Practice address
22385 FLORA PARK CROSSING DRIVE, FERNANDINA BEACH, FL 32034
(904) 404-8641
(904) 227-3246
Mailing address
100 PROFESSIONAL CENTER DR, BRUNSWICK, GA 31525-6743
(912) 574-5075
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
05/28/2024
Last updated
05/28/2024
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