Provider Demographics
NPI:1891155107
Name:COAST TO COAST MEDICAL
Entity Type:Organization
Organization Name:COAST TO COAST MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:SEAN
Authorized Official - Last Name:COURTNEY
Authorized Official - Suffix:
Authorized Official - Credentials:DME
Authorized Official - Phone:720-581-4607
Mailing Address - Street 1:11833 PRAIRIE HARVEST CT
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-3052
Mailing Address - Country:US
Mailing Address - Phone:720-581-4607
Mailing Address - Fax:303-841-7136
Practice Address - Street 1:11833 PRAIRIE HARVEST CT
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-3052
Practice Address - Country:US
Practice Address - Phone:720-581-4607
Practice Address - Fax:303-841-7136
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-29
Last Update Date:2016-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies