| Organization Name: | COASTAL OXYGEN & MEDICAL SUPPLY, LLC |
| NPI Number: | 1003848748 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DONALD R PADGET (MEMBER) |
| Mailing Address: | 2411 Executive Plaza Dr Pensacola |
| State: | FL US |
| Postal Code: | 325048269 |
| Phone Number: | 8504779384 |
| Fax Number: | 8504769519 |
| NPI Enumeration Date: | 07/06/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BX2000X |
| License Number: | 1312081 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Oxygen Equipment & Supplies |
| Taxonomy Definition: | |