Organization
COASTAL MEDICAL INC.
Active
Other names
Coastal Medical Imaging
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MERYL MOSS (COO)
(401) 421-4000
Entity
Organization
Contact information
Practice address
900 WARREN AVE, SUITE 100, EAST PROVIDENCE, RI 02914-1430
(401) 383-9662
(401) 383-6526
Mailing address
10 DAVOL SQUARE, SUITE 400, PROVIDENCE, RI 02903
(401) 421-4000
(401) 272-1456
Taxonomy
Speciality
Code
Description
License number
State
207RM1200X
Magnetic Resonance Imaging (MRI) Internal Medicine Physician
—
—
2085B0100X
Body Imaging Physician
—
—
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CM67577
—
RI
Enumeration date
10/25/2006
Last updated
02/17/2016
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