Provider Demographics
NPI:1881674851
Name:USCG AIR STATION CLEARWATER CLINIC
Entity Type:Organization
Organization Name:USCG AIR STATION CLEARWATER CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF, HEALTH SERVICES DIVISION
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:BELCHER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:727-535-1437
Mailing Address - Street 1:15100 RESCUE WAY
Mailing Address - Street 2:USCG AIR STATION CLEARWATER CLINIC
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33762-3524
Mailing Address - Country:US
Mailing Address - Phone:727-535-1437
Mailing Address - Fax:727-535-4190
Practice Address - Street 1:15100 RESCUE WAY
Practice Address - Street 2:USCG AIR STATION CLEARWATER CLINIC
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33762-3524
Practice Address - Country:US
Practice Address - Phone:727-535-1437
Practice Address - Fax:727-535-4190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1100XAmbulatory Health Care FacilitiesClinic/CenterMilitary/U.S. Coast Guard Outpatient