Provider Demographics
NPI:1114992716
Name:COASTAL EMS, INC.
Entity Type:Organization
Organization Name:COASTAL EMS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-894-8033
Mailing Address - Street 1:13300 SCHROEDER RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-4232
Mailing Address - Country:US
Mailing Address - Phone:281-894-8033
Mailing Address - Fax:281-894-7360
Practice Address - Street 1:13300 SCHROEDER RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-4232
Practice Address - Country:US
Practice Address - Phone:281-894-8033
Practice Address - Fax:281-894-7360
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1012703416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXAMB153Medicare ID - Type Unspecified