MEDICARE: LILI COYLE

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
1	163WH0200X	Home Health Registered Nurse	218684	SC

General Provider Information

NPI Number	:	1447084108
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LILI COYLE

Provider Business Mailing Address
First Line	:	1113 48TH AVE N STE 118
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29577-5441
Country	:	US
Telephone Number	:	843-692-2557
Fax Number	:	843-692-2746

Provider Business Practice Location Address
First Line	:	1113 48TH AVE N STE 118
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29577-5441
Country	:	US
Telephone Number	:	843-692-2557
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/27/2024
Last Update Date	:	08/27/2024

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Directions to “ LILI COYLE ” Practice Location

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