MEDICARE: COASTAL HEARING CENTERS, 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
1	261QH0700X	Hearing and Speech Clinic/Center

General Provider Information

NPI Number	:	1629631650
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COASTAL HEARING CENTERS, INC

Provider Business Mailing Address
First Line	:	PO BOX 1679
Second Line	:
City	:	SHALLOTTE
State	:	NC
Zip	:	28459-1679
Country	:	US
Telephone Number	:	910-755-2428
Fax Number	:

Provider Business Practice Location Address
First Line	:	3806 SAWTELL RD
Second Line	:
City	:	LITTLE RIVER
State	:	SC
Zip	:	29566-7873
Country	:	US
Telephone Number	:	843-399-9950
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SUSAN EVANS GORE
Credential	:
Telephone Number	:	910-755-2428

Provider Enumeration Date	:	04/16/2019
Last Update Date	:	03/31/2026

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