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General NPI Number Information
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NPI Number | 1144315540
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Entity Type | Organization
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Legal Business Name | UNITED STATES COAST GUARD
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1 MUNRO AVE
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City | CAPE MAY
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State | NJ
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Zip | 08204-5000
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Country | US
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Telephone | 609-898-6966
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Fax | 609-898-6962
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Provider Business Mailing Address
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Address Line | 1 MUNRO AVE
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City | CAPE MAY
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State | NJ
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Zip | 08204-5000
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Country | US
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Telephone | 609-898-6966
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Fax | 609-898-6962
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Authorized Official
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Title or Position | HEALTH SERVICES TECHNICAN
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Name | MRS. MARIA INEZ DICKINSON
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Credential |
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Telephone | 609-898-6966
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | 24720000X
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License Number State | DC
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