Organization
COASTAL COMMUNITY HEALTH SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAVANAUGH CHANDLER MD (CEO)
(912) 275-8028
Entity
Organization
Contact information
Practice address
1600 ELLIS ST, BRUNSWICK, GA 31520-6737
(912) 289-2006
(912) 289-2014
Mailing address
106 SHOPPERS WAY STE 114, BRUNSWICK, GA 31525-0522
(912) 574-5075
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
08/30/2022
Last updated
08/30/2022
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