Coastal Prosthetic & Orthotic Laboratory Inc

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

026218673 Issued in SC

Legal business name

COASTAL PROSTHETIC & ORTHOTIC LABORATORY INC

Practice address

11871 Plaza Drive
Suite 6
Murrells Inlet, SC 29576-9351

Phone

(843) 651-8570

Fax

(843) 651-2461

NPI assigned

Nov 3, 2005

Organization subpart

No

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

Authorized official

Name

Mr. William C Vann, CPO

Title

President

Phone

(843) 651-8570

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1130976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1293494400000",
    "number": "1720079262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11871 PLAZA DRIVE",
            "address_2": "SUITE 6",
            "city": "MURRELLS INLET",
            "state": "SC",
            "postal_code": "295769351",
            "telephone_number": "843-651-8570",
            "fax_number": "843-651-2461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11871 PLAZA DRIVE",
            "address_2": "SUITE 6",
            "city": "MURRELLS INLET",
            "state": "SC",
            "postal_code": "295769351",
            "telephone_number": "843-651-8570",
            "fax_number": "843-651-2461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL PROSTHETIC & ORTHOTIC LABORATORY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-03",
        "last_updated": "2010-12-28",
        "status": "A",
        "authorized_official_last_name": "VANN",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "843-651-8570",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPO"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "SC",
            "license": "026218673",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "557506",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Coastal Eye Management LLC
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• Coastal House Calls
• Coastal House Calls, PC
• Coastal Palm Orthodontics LLC
• Daniel L Coe
• Adrienne Neale Coggin, MA, LPC, NCC
• Charles Stephen Coggins
• Adrienne Cohen
• Craig Steven Cohen, DC

• Prosthetic/Orthotic Supplier in Murrells Inlet, SC
• Providers in Murrells Inlet, SC by specialty
• Prosthetic/Orthotic Supplier in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2010; 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.