MEDICARE: COASTAL HOME HEALTH & HOSPICE INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251G00000X	Community Based Hospice Care Agency	16-1052	OR

General Provider Information

NPI Number	:	1750678801
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COASTAL HOME HEALTH & HOSPICE INC.

Provider Business Mailing Address
First Line	:	PO BOX 6042
Second Line	:
City	:	BROOKINGS
State	:	OR
Zip	:	97415-0137
Country	:	US
Telephone Number	:	541-469-0405
Fax Number	:	541-469-6185

Provider Business Practice Location Address
First Line	:	585 5TH ST
Second Line	:
City	:	BROOKINGS
State	:	OR
Zip	:	97415-9702
Country	:	US
Telephone Number	:	541-469-0405
Fax Number	:	541-469-6185

Authorized Official
Title or Position	:	CEO
Name	:	JAMIE DAUGHERTY
Credential	:	RN
Telephone Number	:	541-512-5041

Provider Enumeration Date	:	07/08/2011
Last Update Date	:	12/22/2025

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