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General NPI Number Information
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NPI Number | 1437658424
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Entity Type | Organization
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Legal Business Name | COASTAL MOBILITY TRANSPORTATION, LLC
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Dates
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Enumeration Date | 02/06/2018
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Last Update Date | 02/06/2018
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Provider Practice Location Address
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Address Line | 203 FOREST PARK CIRCLE
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City | PANAMA CITY
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State | FL
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Zip | 32405
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Country | US
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Telephone |
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Fax |
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Provider Business Mailing Address
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Address Line | 93 MONTCLAIR AVE
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City | SANTA ROSA BEACH
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State | FL
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Zip | 32459-0601
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Country | US
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Telephone | 205-515-8752
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JARED SCHNADER
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Credential |
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Telephone | 850-780-3503
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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