Provider Demographics
NPI:1891976809
Name:COGGINS INSURANCE AGENCY
Entity Type:Organization
Organization Name:COGGINS INSURANCE AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:KENNETH
Authorized Official - Last Name:COGGINS
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:864-596-9922
Mailing Address - Street 1:364 S PINE ST
Mailing Address - Street 2:SUITE B 130
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29302-2655
Mailing Address - Country:US
Mailing Address - Phone:864-596-9922
Mailing Address - Fax:864-596-8823
Practice Address - Street 1:364 S PINE ST
Practice Address - Street 2:SUITE B 130
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29302-2655
Practice Address - Country:US
Practice Address - Phone:864-596-9922
Practice Address - Fax:864-596-8823
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-19
Last Update Date:2008-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC5769700001Medicare NSC