Provider Demographics
NPI:1417635061
Name:COASTAL HEALTHCARE PLC
Entity Type:Organization
Organization Name:COASTAL HEALTHCARE PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:JOY
Authorized Official - Last Name:LAZOS
Authorized Official - Suffix:
Authorized Official - Credentials:AGNP
Authorized Official - Phone:757-316-5800
Mailing Address - Street 1:7889 SUNSET DR
Mailing Address - Street 2:
Mailing Address - City:HAYES
Mailing Address - State:VA
Mailing Address - Zip Code:23072-3624
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7889 SUNSET DR
Practice Address - Street 2:
Practice Address - City:HAYES
Practice Address - State:VA
Practice Address - Zip Code:23072-3624
Practice Address - Country:US
Practice Address - Phone:757-746-4090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-05
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health