Organization
COASTAL MED TECH INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON E SEVEY (COMPLIANCE OFFICER)
(207) 848-7152
Entity
Organization
Contact information
Practice address
25 DOUGLAS HWY, ELLSWORTH, ME 04605-0791
(800) 544-1113
(207) 667-3099
Mailing address
25 DOUGLAS HIGHWAY, ELLSWORTH, ME 04605
(207) 667-2508
(207) 667-3099
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
227424
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
118860000
—
ME
Enumeration date
05/23/2005
Last updated
11/16/2016
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