Coastline Ambulance LLC

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

COASTLINE AMBULANCE LLC

Practice address

1400 Church St Ste 300B
Conway, SC 29526-4159

Phone

(843) 712-5767

NPI assigned

Apr 24, 2025

Organization subpart

No

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

Authorized official

Name

Mr. Brent Matthew Johns, PARAMEDIC

Title

Co-Owner

Phone

(843) 356-2326

Specialties & licenses 1

Addresses

Other names 1

• Coastline Ambulance LLC Doing business as

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1745452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746403200000",
    "number": "1275320855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 478",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295280478",
            "telephone_number": "843-712-5767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 CHURCH ST STE 300B",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295264159",
            "telephone_number": "843-712-5767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTLINE AMBULANCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-24",
        "last_updated": "2025-05-05",
        "certification_date": "2025-05-05",
        "status": "A",
        "authorized_official_last_name": "JOHNS",
        "authorized_official_first_name": "BRENT",
        "authorized_official_middle_name": "MATTHEW",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "843-356-2326",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PARAMEDIC"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coastline Ambulance LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Coastline Ambulance LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Coastal Orthopedic Associates, PA
• Coastal Pediatrics
• Coastal Pediatrics
• Coastal Podiatry Associates PA
• Coastal Urology Center, PA
• John Oliver Cochran, D.C.
• Rebecca Marie Cochran, MSW
• John Michael Coffman, RPH
• Robert L Coffman Jr.
• Lauren E Colbert

• Land Ambulance in Conway, SC
• Providers in Conway, SC by specialty
• Land Ambulance in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.