Provider Demographics
NPI:1295713774
Name:US COAST GUARD
Entity type:Organization
Organization Name:US COAST GUARD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TECHNICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:JEREMIAH
Authorized Official - Middle Name:T
Authorized Official - Last Name:MCCARY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-441-6508
Mailing Address - Street 1:COMDT (CG-1122) US COAST GUARD
Mailing Address - Street 2:2100 2ND ST SW SUITE 5314
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20593
Mailing Address - Country:US
Mailing Address - Phone:251-441-6560
Mailing Address - Fax:
Practice Address - Street 1:COMDT (CG-1122) US COAST GUARD
Practice Address - Street 2:2100 2ND ST SW SUITE 5314
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20593
Practice Address - Country:US
Practice Address - Phone:251-441-6560
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherGroup - Single Specialty