Organization Name: | COASTAL FAMILY HEALTH CENTER INC |
NPI Number: | 1033107289 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOE M DAWSEY (EXECUTIVE DIRECTOR) |
Mailing Address: | 15024 Martin Luther King Jr Blvd Gulfport |
State: | MS US |
Postal Code: | 395018306 |
Phone Number: | 2288640003 |
Fax Number: | 2283740856 |
NPI Enumeration Date: | 10/12/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QC1500X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Community Health |
Taxonomy Definition: |