COASTAL AMBULANCE CO.,INC (NPI# 1134155575) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134155575 |
| Entity Type | Organization |
| Organization Name | COASTAL AMBULANCE CO.,INC |
| Practice Address |
194 Thomas Loop Rd Jacksonville NC 28540-8518 |
| Practice Telephone | 9103246304 |
| Practice Fax Number | 9103243040 |
| Mailing Telephone | 9103246304 |
| Mailing Fax Number | 9103243040 |
| Enumeration Date | 2006-06-25 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. H.STEVEN PRIDGEN (OWNER/DIRECTOR) |
| Authorized Official Telephone | 9103246304 |
| Authorized Official Credential | TEACHER,PARAMEDI |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 146N00000X | Emergency Medical Technician, Basic | 0520902 | NC | Emergency Medical Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 3406781 | 05 |
| Street Address |
194 THOMAS LOOP RD |
| City | JACKSONVILLE |
| State | NC |
| Zip Code | 28540-8518 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467067785 | Knox Counseling and Consulting, PC | Case Management | 513 New Bridge St-suite 500, Jacksonville, NC 28540 | 2020-09-14 |
| 1629696646 | Mary Ann Caldwell | Counselor | 2496 Northwoods Dr., Jacksonville, NC 28540 | 2020-07-07 |
| 1639793748 | Johnathon T Brewer | Military Health Care Provider | 100 White St, Jacksonville, NC 28540 | 2020-06-04 |
| 1043782899 | Brice Rivra | Military Health Care Provider | Rr 612 Loop Road, Jacsksonvile, NC 28540 | 2018-12-18 |
| 1649768599 | Alexander John Pybus | Student in an Organized Health Care Education/Training Program | White St Bldg As-100, Jacksonville, NC 28540 | 2018-04-26 |
| 1881198182 | Orleiquis Guerra | Military Health Care Provider | Marine Corps Air Station New River Bldg As-100, Jacksonville, NC 28540 | 2018-03-21 |
| 1558864736 | Andrew Louis Monroe | General Practice | As-100 White Street, Jacksonville, NC 28540 | 2018-03-14 |
| 1588183198 | Citizen Community Transport, LLC | Private Vehicle | 220 Foxwood Ct., Jacksonville, NC 28540 | 2017-09-14 |
| 1558886242 | Brandon Jay Smith | Military Health Care Provider | E Street Bldg G770, Camp Lejeune, NC 28540 | 2017-08-03 |
| 1174043244 | Jason Waters | Military Health Care Provider | White St, Bldg As-100, Jacksonville, NC 28540 | 2017-06-21 |
| Find all providers in zip 28540 | ||||
| Taxonomy Code | 146N00000X |
| Grouping | Emergency Medical Service Providers |
| Classification | Emergency Medical Technician, Basic |
| A Basic EMT is an individual trained and certified to perform basic life support treatment in medical emergencies based on individual state boards. |
| Notes: Sources: Tabers Medical Dictionary and Florida EMS Clearing House. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508316084 | Melissa Angel | Emergency Medical Technician, Basic | 3701 Winton Drive, Jacksonville, FL 32208 | 2016-10-10 |
| 1801010293 | Larry Barnes | Emergency Medical Technician, Basic | 325 Western Blvd, Jacksonville, NC 28546-6341 | 2007-04-13 |
| 1831219674 | Charles Conrad Redeker Jr. | Emergency Medical Technician, Basic | 325 Western Blvd, Jacksonville, NC 28546-6341 | 2007-03-29 |
| 1376683243 | Edward Jason Crum | Emergency Medical Technician, Basic | 4200 Ocean St, Jacksonville, FL 32233-2416 | 2007-02-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023659075 | Luis Cortes Rosales | Emergency Medical Technician, Basic | 436 Planters Way, Mount Holly, NC 28120-9070 | 2019-10-01 |
| 1245721968 | Dominique Lillian Mccray | Emergency Medical Technician, Basic | 2000 Campana Dr, Raleigh, NC 27603-9492 | 2018-05-29 |
| 1053813261 | Christina Turner | Emergency Medical Technician, Basic | 4111 Oakdale Dr, Ayden, NC 28513-7076 | 2018-03-03 |
| 1114445152 | Jordyn Lopez | Emergency Medical Technician, Basic | 400 Atlantic Christian Col Dr Ne, Wilson, NC 27893-2505 | 2017-08-30 |
| 1851762215 | Michael Benusa | Emergency Medical Technician, Basic | 226 Woodland Dr, Raeford, NC 28376-5410 | 2015-10-12 |
| 1457728644 | Vanessa Brooks | Emergency Medical Technician, Basic | 1901 Mooney Street, Winston-salem, NC 27103 | 2015-08-24 |
| 1619364304 | Ericka Riddle | Emergency Medical Technician, Basic | 7334 Matthews Mint Hill Rd, Mint Hill, NC 28227-7594 | 2015-04-20 |
| 1922498278 | Ana Baynes | Emergency Medical Technician, Basic | 117 Brookfield Dr, Stokesdale, NC 27357 | 2015-01-26 |
| 1609279009 | Noah Okafor | Emergency Medical Technician, Basic | 4804 Swanns Mill Dr, Durham, NC 27704-1492 | 2014-09-30 |
| 1598172645 | Amalya Kali Wright | Emergency Medical Technician, Basic | 5315 Dana Dr Apt F, Raleigh, NC 27606 | 2014-07-21 |
| Find all providers with the same taxonomy | ||||
| City | JACKSONVILLE |
| Zip Code | 28540 |
Please comment or provide details below to improve the information on COASTAL AMBULANCE CO.,INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.