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Contact Information

COASTAL PHYSICAL MEDICINE, PA
3185 AZALEA DR
NORTH CHARLESTON, SC29405-8211
 Phone: 843-762-2274
 Fax: 843-762-2278
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Medical Specialty

261QM2500X
Indicates primary specialty

NPI Profile & details for COASTAL PHYSICAL MEDICINE, PA

NPI Number 1053580662
LBN Legal business name COASTAL PHYSICAL MEDICINE, PA
Authorized official REBECCA MCSWAIN - (PRACTICE MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 02/27/2008
Last updated 02/27/2008 - About 18 years ago
Identifiers
SC License # 19612
SC Medicaid GP2989
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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