Provider Demographics
NPI:1336559228
Name:COASTAL MEDICAL CARE
Entity Type:Organization
Organization Name:COASTAL MEDICAL CARE
Other - Org Name:WALDO COUNTY DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:DRINKWATER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-338-2500
Mailing Address - Street 1:118 NORTHPORT AVE
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-6009
Mailing Address - Country:US
Mailing Address - Phone:207-338-3368
Mailing Address - Fax:207-338-6207
Practice Address - Street 1:125 NORTHPORT AVE STE 107
Practice Address - Street 2:
Practice Address - City:BELFAST
Practice Address - State:ME
Practice Address - Zip Code:04915-6002
Practice Address - Country:US
Practice Address - Phone:207-338-3368
Practice Address - Fax:207-338-6207
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-01
Last Update Date:2014-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental