Provider Demographics
NPI:1295113868
Name:COAST TO COAST MEDICAL TRANSPORTATION
Entity type:Organization
Organization Name:COAST TO COAST MEDICAL TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PEGGY
Authorized Official - Middle Name:
Authorized Official - Last Name:WIGGINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-714-7795
Mailing Address - Street 1:2128 US HIGHWAY 41 N
Mailing Address - Street 2:
Mailing Address - City:PERRY
Mailing Address - State:GA
Mailing Address - Zip Code:31069-9784
Mailing Address - Country:US
Mailing Address - Phone:888-228-0632
Mailing Address - Fax:478-333-6320
Practice Address - Street 1:2128 US HIGHWAY 41 N
Practice Address - Street 2:
Practice Address - City:PERRY
Practice Address - State:GA
Practice Address - Zip Code:31069-9784
Practice Address - Country:US
Practice Address - Phone:888-228-0632
Practice Address - Fax:478-333-6320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-14
Last Update Date:2017-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA076-033416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport