Provider Demographics
NPI:1205311685
Name:COASTAL CAB COMPANY LLC
Entity type:Organization
Organization Name:COASTAL CAB COMPANY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:L
Authorized Official - Last Name:EATMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-464-4324
Mailing Address - Street 1:1250 6TH ST
Mailing Address - Street 2:
Mailing Address - City:CRESCENT CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95531-2803
Mailing Address - Country:US
Mailing Address - Phone:707-464-4324
Mailing Address - Fax:
Practice Address - Street 1:1250 6TH ST
Practice Address - Street 2:
Practice Address - City:CRESCENT CITY
Practice Address - State:CA
Practice Address - Zip Code:95531-2803
Practice Address - Country:US
Practice Address - Phone:707-464-4324
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-01
Last Update Date:2018-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi