Healthcare Provider Details

I. General information

NPI: 1811078314
Provider Name (Legal Business Name): UNITED STATES COAST GUARD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 2ND ST SW SUITE 5314
WASHINGTON DC
20593-0002
US

IV. Provider business mailing address

2100 2ND STREET, SOUTHWEST SUITE 5314
WASHINGTON DC
20593
US

V. Phone/Fax

Practice location:
  • Phone: 508-968-6572
  • Fax: 508-968-6581
Mailing address:
  • Phone: 508-968-6572
  • Fax: 508-968-6581

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2865M2000X
TaxonomyMilitary General Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: MS. RACHEL ANN HAYES
Title or Position: HEALTH SERVICES TECHNITION
Credential:
Phone: 508-968-6729