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NPI Code Detail

MEDICARE: COASTAL THERAPY SERVICES, INC.

MEDICARE: COASTAL THERAPY SERVICES, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist
2225X00000XOccupational Therapist
3235Z00000XSpeech-Language Pathologist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1285641308
Entity Type Code : Organization
Provider Name (Legal Business Name) : COASTAL THERAPY SERVICES, INC.
Provider Business Mailing Address
First Line : PO BOX 1753
Second Line :
City : MT PLEASANT
State : SC
Zip : 29465-1753
Country : US
Telephone Number : 843-216-0290
Fax Number : 843-216-2445
Provider Business Practice Location Address
First Line : 1127 QUEENSBOROUGH BLVD STE 104
Second Line :
City : MT PLEASANT
State : SC
Zip : 29464-5431
Country : US
Telephone Number : 843-216-0290
Fax Number : 843-216-2445
Authorized Official
Title or Position : OWNER
Name : RON THAYER
Credential : CCC-SLP
Telephone Number : 843-216-0290
Provider Enumeration Date : 08/02/2006
Last Update Date : 06/23/2015

Similar Medicare Providers

1073537932 — PAMELA JILL SHULER CCC-SLP
Practice Location Address:
1127 QUEENSBOROUGH BLVD STE 104
MT PLEASANT, SC
29464-5431
Practice Phone: 843-216-0290
Practice Fax:
1649361080 — RITU SHARMA RPT
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1127 QUEENSBOROUGH BLVD STE 104
MT PLEASANT, SC
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Practice Fax: 843-216-2445
1285891812 — KELLY LYNN QUICK
Practice Location Address:
1127 QUEENSBOROUGH BLVD STE 104
MT PLEASANT, SC
29464-5431
Practice Phone: 843-216-0290
Practice Fax:
1245465772 — MRS. HARRIET C HETZEL MED,CCC,SLP
Practice Location Address:
1127 QUEENSBOROUGH BLVD STE 104
MT PLEASANT, SC
29464-5431
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Practice Fax:
1962728782 — MRS. LINDSAY W DEW
Practice Location Address:
1127 QUEENSBOROUGH BLVD , SUITE 104
MT PLEASANT, SC
29464-5431
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Practice Fax: 843-216-2445
1174804967 — ELIZABETH ANN GAGE
Practice Location Address:
1127 QUEENSBOROUGH BLVD STE 104
MT PLEASANT, SC
29464-5431
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Practice Fax:

Directions to “COASTAL THERAPY SERVICES, INC. ” Practice Location

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