MEDICARE: COASTLIFT MEDICAL TRANSPORT, LLC

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	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1821924424
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COASTLIFT MEDICAL TRANSPORT, LLC

Provider Business Mailing Address
First Line	:	944 KINGS BAY ROAD
Second Line	:	STE A, PMB 102
City	:	SAINT MARYS
State	:	GA
Zip	:	31558
Country	:	US
Telephone Number	:	912-464-3780
Fax Number	:

Provider Business Practice Location Address
First Line	:	944 KINGS BAY ROAD
Second Line	:	STE A, PMB 102
City	:	SAINT MARYS
State	:	GA
Zip	:	31558
Country	:	US
Telephone Number	:	912-464-3780
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	SHEENA GARDNER
Credential	:
Telephone Number	:	912-464-3780

Provider Enumeration Date	:	06/22/2026
Last Update Date	:	06/22/2026

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