Healthcare Provider Details

I. General information

NPI: 1649746231
Provider Name (Legal Business Name): COAST2COAST PUBLIC SAFETY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2018
Last Update Date: 12/11/2019
Certification Date: 12/11/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 PLEASANT ST
MARTINSBURG OH
43037
US

IV. Provider business mailing address

PO BOX 174
MARTINSBURG OH
43037-0174
US

V. Phone/Fax

Practice location:
  • Phone: 833-262-7877
  • Fax: 833-262-7877
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State

VIII. Authorized Official

Name: JAMES POTTER
Title or Position: MEMBER / MANAGER
Credential:
Phone: 833-262-7877