Provider Demographics
NPI:1245422112
Name:COASTAL AIR, INC
Entity Type:Organization
Organization Name:COASTAL AIR, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:REGINA
Authorized Official - Middle Name:L
Authorized Official - Last Name:SIMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-860-9100
Mailing Address - Street 1:PO BOX 14848
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30919-0848
Mailing Address - Country:US
Mailing Address - Phone:706-860-9100
Mailing Address - Fax:706-396-2100
Practice Address - Street 1:1109 MEDICAL CENTER DR
Practice Address - Street 2:BLDG 4
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30909-6633
Practice Address - Country:US
Practice Address - Phone:706-860-9100
Practice Address - Fax:706-396-2100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-15
Last Update Date:2007-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416A0800XTransportation ServicesAmbulanceAir Transport