Provider Demographics
NPI:1891019584
Name:EAST COAST MEDICAL LLC
Entity Type:Organization
Organization Name:EAST COAST MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:HYE
Authorized Official - Middle Name:KYONG
Authorized Official - Last Name:YANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-787-2282
Mailing Address - Street 1:133 DELAWARE AVE
Mailing Address - Street 2:
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-3013
Mailing Address - Country:US
Mailing Address - Phone:410-787-2282
Mailing Address - Fax:410-787-2281
Practice Address - Street 1:7509 CONNELLEY DR STE N
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:MD
Practice Address - Zip Code:21076-1664
Practice Address - Country:US
Practice Address - Phone:410-787-2282
Practice Address - Fax:410-787-2281
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies