Coastal Breeze Healthcare

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

COASTAL BREEZE HEALTHCARE

Practice address

517 S Norwood St
Wallace, NC 28466-1619

Phone

(910) 714-8164

NPI assigned

Aug 26, 2013

Last updated

Aug 26, 2013By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Dwayne D. Furmidge

Title

Ceo

Phone

(910) 620-9500

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1377475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377475200000",
    "number": "1033543178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "517 S NORWOOD ST",
            "city": "WALLACE",
            "state": "NC",
            "postal_code": "284661619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "517 S NORWOOD ST",
            "city": "WALLACE",
            "state": "NC",
            "postal_code": "284661619",
            "telephone_number": "910-714-8164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL BREEZE HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-26",
        "last_updated": "2013-08-26",
        "status": "A",
        "authorized_official_last_name": "FURMIDGE",
        "authorized_official_first_name": "DWAYNE",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "910-620-9500",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Wallace, NC
• Providers in Wallace, NC by specialty
• Community/Behavioral Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.