Provider Demographics
NPI:1114298205
Name:COASTAL HOMECARE PHYSICIANS, LLC
Entity Type:Organization
Organization Name:COASTAL HOMECARE PHYSICIANS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:MELI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-489-6711
Mailing Address - Street 1:PO BOX 681
Mailing Address - Street 2:
Mailing Address - City:ALLENWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08720-0681
Mailing Address - Country:US
Mailing Address - Phone:888-908-3701
Mailing Address - Fax:888-235-0243
Practice Address - Street 1:3232 RAMBLING HILL CT
Practice Address - Street 2:
Practice Address - City:ALLENWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08720-7024
Practice Address - Country:US
Practice Address - Phone:888-908-3701
Practice Address - Fax:888-235-6711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-20
Last Update Date:2012-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA061977208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty