Healthcare Provider Details

I. General information

NPI: 1215660899
Provider Name (Legal Business Name): COASTLINE ANESTHESIA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2022
Last Update Date: 12/27/2022
Certification Date: 12/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 LAMBERT LIND HWY STE 100
WARWICK RI
02886-1074
US

IV. Provider business mailing address

55 LAMBERT LIND HWY STE 100
WARWICK RI
02886-1074
US

V. Phone/Fax

Practice location:
  • Phone: 401-737-4711
  • Fax:
Mailing address:
  • Phone: 401-737-4711
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DEBORAH CAHILL
Title or Position: ANESTHESIOLOGIST
Credential: MD
Phone: 401-737-4711