| Coastal Concierge Health, Pllc | |
|
801 N Howe St Ste 5 Southport NC 28461-3351 | |
| (910) 622-0952 | |
| Not Available |
| Full Name | Coastal Concierge Health, Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 801 N Howe St Ste 5, Southport, North Carolina |
| Authorized Official Name and Position | Matthew Lucas (NP) |
| Authorized Official Contact | 9106220952 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Coastal Concierge Health, Pllc 801 N Howe St Ste 5 Southport NC 28461-3351 Ph: (910) 622-0952 | Coastal Concierge Health, Pllc 801 N Howe St Ste 5 Southport NC 28461-3351 Ph: (910) 622-0952 |
| NPI Number | 1184459661 |
|---|---|
| Provider Enumeration Date | 09/04/2024 |
| Last Update Date | 06/03/2025 |
| Medicare PECOS PAC ID | 8123557535 |
|---|---|
| Medicare Enrollment ID | O20250130001854 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184459661 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Matthew J Lucas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245776814 PECOS PAC ID: 0143506238 Enrollment ID: I20170403001948 |
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