| Coastal Community Health Services, Inc. | |
|
308 Bedell Ave Woodbine GA 31569-2091 | |
| (912) 275-8028 | |
| Not Available |
| Full Name | Coastal Community Health Services, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 308 Bedell Ave, Woodbine, Georgia |
| Authorized Official Name and Position | Kavanaugh Chandler (CEO) |
| Authorized Official Contact | 9122758028 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Coastal Community Health Services, Inc. 100 Professional Center Dr Brunswick GA 31525-6743 Ph: (912) 275-8028 | Coastal Community Health Services, Inc. 308 Bedell Ave Woodbine GA 31569-2091 Ph: (912) 275-8028 |
| NPI Number | 1225808199 |
|---|---|
| Provider Enumeration Date | 01/03/2024 |
| Last Update Date | 01/03/2024 |
| Medicare PECOS PAC ID | 0345463683 |
|---|---|
| Medicare Enrollment ID | O20240612001356 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225808199 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Mary Lee Carter, Md-pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 308 Bedell Ave, Woodbine, GA 31569 Phone: 912-576-5999 Fax: 912-576-5888 |