Healthcare Provider Details

I. General information

NPI: 1932046844
Provider Name (Legal Business Name): COASTAL RIDGE HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 THE GRN # 8543
DOVER DE
19901-3618
US

IV. Provider business mailing address

8 THE GRN # 8543
DOVER DE
19901-3618
US

V. Phone/Fax

Practice location:
  • Phone: 302-551-7889
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: LAMAR CHASE
Title or Position: MANAGER
Credential:
Phone: 302-551-7889