Provider Demographics
NPI:1417601592
Name:COASTAL MEDICAL EQUIPMENT LLC
Entity Type:Organization
Organization Name:COASTAL MEDICAL EQUIPMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:TERREBONNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:228-731-3313
Mailing Address - Street 1:450 E PASS RD STE 1
Mailing Address - Street 2:
Mailing Address - City:GULFPORT
Mailing Address - State:MS
Mailing Address - Zip Code:39507-3212
Mailing Address - Country:US
Mailing Address - Phone:228-731-3313
Mailing Address - Fax:228-731-3313
Practice Address - Street 1:450 E PASS RD STE 1
Practice Address - Street 2:
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39507-3212
Practice Address - Country:US
Practice Address - Phone:228-731-3313
Practice Address - Fax:833-346-0381
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-08
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies