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General NPI Number Information
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NPI Number | 1447330246
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Entity Type | Organization
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Legal Business Name | UNITIED STATES COAST GUARD
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Dates
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Enumeration Date | 10/16/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2100 2ND ST SW COMDT (CG-1122) SUITE 5314 US COAST GUARD
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City | WASHINGTON
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State | DC
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Zip | 20593
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Country | US
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Telephone | 609-898-6610
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Fax |
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Provider Business Mailing Address
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Address Line | 1410 DELAWARE AVE APT C
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City | CAPE MAY
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State | NJ
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Zip | 08204-4037
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Country | US
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Telephone | 609-898-3368
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Fax |
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Authorized Official
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Title or Position | TECHNICIAN
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Name | NICOLE LYNN FLORES
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Credential | HS
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Telephone | 609-898-6864
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 247200000X
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Taxonomy Name | Other Technician
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License Number |
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License Number State |
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