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Contact Information

EXTENDED CARE PHYSICIANS - COASTAL, PA
1013 PORTERS NECK RD
SUITE 130
WILMINGTON, NC28411-8130
 Phone: 910-795-1471
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Geriatric Medicine

207QG0300X 08 Physician/Family Practice
 

Family

363LF0000X 50 Nurse Practitioner
 

Geriatric Medicine

207RG0300X 11 Physician/Internal Medicine
 

Geriatric Psychiatry

2084P0805X 86 Physician/Neuropsychiatry
 

Gerontology

363LG0600X 50 Nurse Practitioner
 

Hospice and Palliative Medicine

207RH0002X 11 Physician/Internal Medicine
 

Hospice and Palliative Medicine

207QH0002X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for EXTENDED CARE PHYSICIANS - COASTAL, PA

NPI # 1114191525
LBN Legal business name EXTENDED CARE PHYSICIANS - COASTAL, PA
Authorized official ROBIN GLEESON-WARREN - (DIRECTOR OF CREDENTIALING)
Entity Organization
Organization subpart 1 No
Enumeration date 04/16/2008
Last updated 03/19/2014 - About 12 years ago
Identifiers
NC Medicaid 5918852
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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