NPI Code Detail JSON Logo

1639647324 NPI number — COASTAL MED-TECH CORP.

NPI Number: 1639647324
Health Care Provider/Practitioner: COASTAL MED-TECH CORP.

Information about “1639647324” NPI (COASTAL MED-TECH CORP.) exists in 1639647324 in HTML format HTML  |  1639647324 in plain Text format TXT  |  1639647324 in PDF (Portable Document Format) PDF  |  1639647324 in an XML format XML  formats.

NPI Number : 1639647324 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1639647324",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "COASTAL MED-TECH CORP.",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": "6",
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1019 TOWN DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "HIGHLAND HEIGHTS",
    "MailingAddressStateName": "KY",
    "MailingAddressPostalCode": "41076-9114",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "859-441-8876",
    "MailingAddressFaxNumber": "859-441-5850",
    "FirstLinePracticeLocationAddress": "177 COLLEGE AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "WATERVILLE",
    "PracticeLocationAddressStateName": "ME",
    "PracticeLocationAddressPostalCode": "04901-6219",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "800-773-6511",
    "PracticeLocationAddressFaxNumber": "207-872-7310",
    "EnumerationDate": "11/12/2018",
    "LastUpdateDate": "03/26/2024",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "CRAWFORD",
    "AuthorizedOfficialFirstName": "GREG",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "PRESIDENT",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "859-441-8876",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "332B00000X",
          "TaxonomyName": "Durable Medical Equipment & Medical Supplies",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "332BX2000X",
          "TaxonomyName": "Oxygen Equipment & Supplies (DME)",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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