COASTAL COMMUNITY HEALTH SERVICES INC. NPI 1730969098

NPI Information

NPI: 1730969098
Provider Name: COASTAL COMMUNITY HEALTH SERVICES, INC.
Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

CLIA Number: 11D2291546

Address:
4621 ALTAMA AVE
BRUNSWICK, GA
ZIP 31520
Phone: (912) 217-9507
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COASTAL COMMUNITY HEALTH SERVICES, INC. is a federally qualified health center (fqhc) clinic center in Brunswick, GA. COASTAL COMMUNITY HEALTH SERVICES, INC. NPI is 1730969098. The provider is registered as an organization entity type.

The provider's business location address is:

4621 ALTAMA AVE
BRUNSWICK, GA
ZIP 31520-908
Phone: (912) 217-9507

The provider's authorized official is Kavanaugh Chandler .
The authorized official title is Ceo and has the following contact phone number (912) 275-8028.

The CLIA number assigned to this NPI record is 11D2291546 - federally qualified health center with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 10/4/2023 and was last updated on 10/4/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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