Provider Demographics
NPI:1518138940
Name:COASTAL AUDIOLOGY INC.
Entity Type:Organization
Organization Name:COASTAL AUDIOLOGY INC.
Other - Org Name:COASTAL AUDIOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:HOSTETLER
Authorized Official - Last Name:MACMILLAN
Authorized Official - Suffix:
Authorized Official - Credentials:AUD, F-AAA
Authorized Official - Phone:912-748-9494
Mailing Address - Street 1:P.O. BOX 52
Mailing Address - Street 2:
Mailing Address - City:POOLER
Mailing Address - State:GA
Mailing Address - Zip Code:31322-4051
Mailing Address - Country:US
Mailing Address - Phone:912-748-9494
Mailing Address - Fax:912-748-9495
Practice Address - Street 1:410 US HIGHWAY 80 SW
Practice Address - Street 2:
Practice Address - City:POOLER
Practice Address - State:GA
Practice Address - Zip Code:31322-2541
Practice Address - Country:US
Practice Address - Phone:912-748-9494
Practice Address - Fax:912-748-9495
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-13
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty