Healthcare Provider Details

I. General information

NPI: 1356426894
Provider Name (Legal Business Name): UNITED STATES COAST GUARD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

END OF ROUTE 238
YORKTOWN VA
23690-5000
US

IV. Provider business mailing address

END OF ROUTE 238
YORKTOWN VA
23690-5000
US

V. Phone/Fax

Practice location:
  • Phone: 757-856-2302
  • Fax: 757-856-2276
Mailing address:
  • Phone: 757-856-2302
  • Fax: 757-856-2276

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1100X
TaxonomyMilitary/U.S. Coast Guard Outpatient Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. ROBERT STEEVES
Title or Position: MEDICAL ADMINISTRATOR
Credential:
Phone: 757-856-2302