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Contact Information

COASTAL MOBILE MEDICAL DOCTOR, PA
203 STAGECOACH DR
JACKSONVILLE, NC28546-9617
 Phone: 910-355-6696
 Fax: 910-355-6696
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Geriatric Medicine

207QG0300X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for COASTAL MOBILE MEDICAL DOCTOR, PA

NPI Number 1306092549
LBN Legal business name COASTAL MOBILE MEDICAL DOCTOR, PA
Authorized official NARENDER ARCOT - (PRESIDENT AND CEO)
Entity Organization
Organization subpart 1 No
Enumeration date 08/07/2008
Last updated 11/20/2008 - About 18 years ago
Identifiers
NC License # 200100829
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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