Provider Demographics
NPI:1851857221
Name:COASTAL MEDICAL TRANSIT, LLC
Entity Type:Organization
Organization Name:COASTAL MEDICAL TRANSIT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-986-7376
Mailing Address - Street 1:24 ETHAN ALLEN DR
Mailing Address - Street 2:
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32164-2904
Mailing Address - Country:US
Mailing Address - Phone:386-986-7376
Mailing Address - Fax:
Practice Address - Street 1:24 ETHAN ALLEN DR
Practice Address - Street 2:
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32164-2904
Practice Address - Country:US
Practice Address - Phone:386-986-0601
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-11
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)