Organization
COASTAL ORTHOPEDIC ASSOCIATES, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. WENDY L MEARES (ADMINISTRATIVE ASSISTANT)
(843) 234-7857
Entity
Organization
Contact information
Practice address
2376 CYPRESS CIRCLE, SUITE 300, CONWAY, SC 29526-8920
(843) 347-7222
(843) 347-3305
Mailing address
2376 CYPRESS CIRCLE, SUITE 300, CONWAY, SC 29526-8920
(843) 347-7222
(843) 347-3305
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0313730001
DME MEDICARE
SC
01
—
42D0675833
CLIA
SC
01
—
DM0418
DME MEDICAID
SC
05
—
PA7162
—
SC
Enumeration date
09/26/2006
Last updated
11/13/2014
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