Provider Demographics
NPI:1396720637
Name:COASTAL TRANSPORTATION SERVICES INC.,
Entity type:Organization
Organization Name:COASTAL TRANSPORTATION SERVICES INC.,
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:ARREDONDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-575-1173
Mailing Address - Street 1:1407 N. WHEELER
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77901-5914
Mailing Address - Country:US
Mailing Address - Phone:361-575-1173
Mailing Address - Fax:361-575-2149
Practice Address - Street 1:1407 N. WHEELER
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77901-4672
Practice Address - Country:US
Practice Address - Phone:361-575-1173
Practice Address - Fax:361-575-2149
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2350163416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXAMB710OtherBLUE CROSS BLUE SHIELD
TXAMB344Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
TXP00081927Medicare ID - Type UnspecifiedRAILROAD MEDICARE