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General NPI Number Information
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NPI Number | 1912848698
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Entity Type | Organization
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Legal Business Name | COAST TO COAST HEALTH GROUP, LLC
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Dates
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Enumeration Date | 04/04/2026
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Last Update Date | 04/04/2026
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Provider Practice Location Address
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Address Line | 5441 S MACADAM AVE STE N
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City | PORTLAND
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State | OR
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Zip | 97239-3822
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Country | US
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Telephone | 919-414-4644
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Fax |
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Provider Business Mailing Address
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Address Line | 110 CRAIGS LNDG
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City | KURE BEACH
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State | NC
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Zip | 28449-3769
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Country | US
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Telephone | 919-414-4644
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Fax |
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | MRS. MEREDITH MADDOX GALVIN
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Credential | PMHNP-BC
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Telephone | 919-414-4644
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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