Provider Demographics
NPI:1952871303
Name:COASTAL BILLING AND HOME CARE SERVICES, LLC
Entity Type:Organization
Organization Name:COASTAL BILLING AND HOME CARE SERVICES, LLC
Other - Org Name:COASTAL BILLING AR COLLECTION SPECIALIST
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ASMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:LACEWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-830-5039
Mailing Address - Street 1:PO BOX 336
Mailing Address - Street 2:
Mailing Address - City:RIEGELWOOD
Mailing Address - State:NC
Mailing Address - Zip Code:28456-0336
Mailing Address - Country:US
Mailing Address - Phone:910-830-5039
Mailing Address - Fax:888-633-7817
Practice Address - Street 1:15 GUM AVE
Practice Address - Street 2:
Practice Address - City:BOLTON
Practice Address - State:NC
Practice Address - Zip Code:28423-8558
Practice Address - Country:US
Practice Address - Phone:910-830-5039
Practice Address - Fax:888-633-7817
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-28
Last Update Date:2022-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1952871303Medicaid