Coastal Ambulance LLC

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

COASTAL AMBULANCE LLC

Practice address

372 Yarmouth Rd
Hyannis, MA 02601-2043

Phone

(508) 694-6687

NPI assigned

Aug 1, 2022

Organization subpart

No

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

Authorized official

Name

Alexandre Theoharidis

Title

Ceo

Phone

(508) 694-6687

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

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

{
    "created_epoch": "1659312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659312000000",
    "number": "1235866278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "372 YARMOUTH RD",
            "city": "HYANNIS",
            "state": "MA",
            "postal_code": "026012043",
            "telephone_number": "508-694-6687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "372 YARMOUTH RD",
            "city": "HYANNIS",
            "state": "MA",
            "postal_code": "026012043",
            "telephone_number": "508-694-6687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL AMBULANCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-01",
        "last_updated": "2022-08-01",
        "certification_date": "2022-08-01",
        "status": "A",
        "authorized_official_last_name": "THEOHARIDIS",
        "authorized_official_first_name": "ALEXANDRE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "508-694-6687"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James M Citrone, PHARMD
• Marissa Ann Clark
• Nathaniel G Clark, MD
• Michelle Elise Clausen, CNM
• Cailin Mary Clements, MD
• Coastal EMS LLC
• Coastal Medical Transportation Services LLC
• Coastal Orthopedics & Associates PC
• Coastal Orthopedics, PC
• Dana Louise Cobb, FNP-C

• Land Ambulance in Hyannis, MA
• Providers in Hyannis, MA by specialty
• Land Ambulance in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.