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General NPI Number Information
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NPI Number | 1750688339
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Entity Type | Organization
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Legal Business Name | COASTAL HEALTH CENTER
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Dates
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Enumeration Date | 02/17/2011
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Last Update Date | 04/30/2015
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Provider Practice Location Address
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Address Line | 37 COMMERCE PARK
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City | ELLSWORTH
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State | ME
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Zip | 04605-3383
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Country | US
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Telephone | 207-667-2422
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Fax | 207-667-0135
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Provider Business Mailing Address
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Address Line | 37 COMMERCE PARK
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City | ELLSWORTH
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State | ME
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Zip | 04605-3383
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Country | US
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Telephone | 207-667-2422
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Fax | 207-667-0135
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Authorized Official
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Title or Position | MD
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Name | DR. STEPHEN H NIGHTINGALE
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Credential | MD
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Telephone | 207-667-2422
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 013394
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License Number State | ME
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