Provider Demographics
NPI:1215177969
Name:COASTLINE AMBULANCE SERVICES OF NEW ENGLAND, LLC
Entity Type:Organization
Organization Name:COASTLINE AMBULANCE SERVICES OF NEW ENGLAND, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:
Authorized Official - Last Name:GARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-737-3777
Mailing Address - Street 1:999 SOUTH BROADWAY
Mailing Address - Street 2:
Mailing Address - City:EAST PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02914-4701
Mailing Address - Country:US
Mailing Address - Phone:401-737-3777
Mailing Address - Fax:401-737-3772
Practice Address - Street 1:99 BLEACHERY COURT
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-1201
Practice Address - Country:US
Practice Address - Phone:401-737-3777
Practice Address - Fax:401-737-3772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-20
Last Update Date:2011-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI3416L0300X3416L0300X
3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport