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General NPI Number Information
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NPI Number | 1124468186
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Entity Type | Organization
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Legal Business Name | D M & D COASTAL INVESTMENTS LLC
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Dates
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Enumeration Date | 07/04/2013
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Last Update Date | 10/28/2014
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Provider Practice Location Address
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Address Line | 1497 A CREIGHTON ROAD
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City | PENSACOLA
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State | FL
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Zip | 32504
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Country | US
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Telephone | 850-497-6908
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Fax | 850-497-6741
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Provider Business Mailing Address
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Address Line | 1497 A CREIGHTON ROAD
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City | PENSACOLA
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State | FL
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Zip | 32504
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Country | US
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Telephone | 850-497-6908
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Fax | 850-497-6741
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Authorized Official
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Title or Position | DIRECTOR/ADMINISTRATOR
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Name | MR. MIKE E. MCKELVAINE
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Credential |
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Telephone | 850-497-6908
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 30211679
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License Number State | FL
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