Organization
COASTAL NURSECARE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. EMILY C. DAVENPORT (PRESIDENT)
(912) 264-0040
Entity
Organization
Contact information
Practice address
3216 SHRINE RD, BRUNSWICK, GA 31520-4325
(912) 264-0040
(912) 261-1292
Mailing address
3216 SHRINE RD, BRUNSWICK, GA 31520-4325
(912) 264-0040
(912) 261-1292
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
063-R-0004
GA
251J00000X
Nursing Care Agency
063-R-0004
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
52100796002
BC/BS
GA
Enumeration date
08/23/2005
Last updated
09/11/2025
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