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General NPI Number Information
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NPI Number | 1326338112
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Entity Type | Organization
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Legal Business Name | COASTLINE AMBULANCE SERVICE LLC
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Dates
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Enumeration Date | 04/13/2011
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Last Update Date | 04/13/2011
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Provider Practice Location Address
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Address Line | 4455 SPID DR STE: 21A
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City | CORPUS CHRISTI
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State | TX
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Zip | 78411-5101
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Country | US
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Telephone | 361-462-7657
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 34837
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City | SAN ANTONIO
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State | TX
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Zip | 78265-4837
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Country | US
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Telephone | 361-462-7657
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | MR. EDUARDO DANIEL
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Credential | EMT-P
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Telephone | 361-462-7657
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number |
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License Number State |
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