Coastline Care Inc

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

1522 Issued in NC

Legal business name

COASTLINE CARE INC

Practice address

124 W Main St
Wallace, NC 28466-2902

Phone

(866) 343-7153

Fax

(757) 787-9436

NPI assigned

Mar 14, 2006

Last updated

Aug 28, 2012By 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. Matthew Ellis

Title

Ar Manager

Phone

75776550029

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346112000000",
    "number": "1437128386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 538330",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303538330",
            "telephone_number": "866-343-7153",
            "fax_number": "757-787-9436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 W MAIN ST",
            "city": "WALLACE",
            "state": "NC",
            "postal_code": "284662902",
            "telephone_number": "866-343-7153",
            "fax_number": "757-787-9436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTLINE CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-14",
        "last_updated": "2012-08-28",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "AR MANAGER",
        "authorized_official_telephone_number": "75776550029",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "NC",
            "license": "1522",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0720C",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "590011105",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3406665",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Orlando Carr
• Ashley Cavenaugh
• Christian's House of Hope, Inc.
• Coastal Breeze Healthcare
• Coastal Carolina Foot & Ankle Association PA
• Community Care Support Services Inc
• Continuum Care Corporation
• Gary Stephen Crawford, M.D.
• Daniel M Ricci M.D. P.a.
• Julianne D Davis, MA

• Land Ambulance in Wallace, NC
• Providers in Wallace, NC by specialty
• Land Ambulance in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2012; 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.