Coastline Medical LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

COASTLINE MEDICAL LLC

Practice address

123 N Main St Unit 206
Berlin, MD 21811-1554

Phone

(410) 202-2770

Fax

(410) 220-0709

NPI assigned

Oct 19, 2020

Organization subpart

No

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

Authorized official

Name

Mr. Mark Hammond

Title

Pres

Phone

(443) 235-4178

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Coastline Medical LLC Doing business as

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

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

Medicare medical equipment & supply locations

Locations

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

{
    "created_epoch": "1603065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662595200000",
    "number": "1295334571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 165",
            "city": "BERLIN",
            "state": "MD",
            "postal_code": "218110165",
            "telephone_number": "410-202-2770",
            "fax_number": "410-220-0709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 N MAIN ST UNIT 206",
            "city": "BERLIN",
            "state": "MD",
            "postal_code": "218111554",
            "telephone_number": "410-202-2770",
            "fax_number": "410-220-0709"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1645 Palm Beach Lakes Blvd Ste 1200",
            "address_purpose": "LOCATION",
            "city": "West Palm Beach",
            "state": "FL",
            "postal_code": "334012214",
            "country_code": "US",
            "telephone_number": "888-684-1724",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COASTLINE MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-19",
        "last_updated": "2022-09-08",
        "certification_date": "2022-07-29",
        "status": "A",
        "authorized_official_last_name": "HAMMOND",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "443-235-4178",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UMR",
            "identifier": "76413562",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.umr.com/tpa-ap-web/?navDeepDive=publicHomeDefaultContentMenu",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "123 N Main St Ste 206",
            "city": "Berlin",
            "state": "MD",
            "country_code": "US",
            "postal_code": "218111001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.umr.com/tpa-ap-web/?navDeepDive=publicHomeDefaultContentMenu",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "123 N Main St Unit 206",
            "city": "Berlin",
            "state": "MD",
            "country_code": "US",
            "postal_code": "218111554",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Coastline Medical LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Durable Medical Equipment & Medical Supplies in Berlin, MD
• Providers in Berlin, MD by specialty
• Durable Medical Equipment & Medical Supplies in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2022; 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.