COASTAL CAROLINA PROSTHETICS & ORTHOTICS, INC. (NPI# 1760583033) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760583033 |
| Entity Type | Organization |
| Organization Name | COASTAL CAROLINA PROSTHETICS & ORTHOTICS, INC. |
| Practice Address |
148 Burnetts Way Ste 104 Suffolk VA 23434-6149 |
| Mailing Address |
106 Medical Dr. Elizabeth City NC 27909 |
| Practice Telephone | 7579342676 |
| Practice Fax Number | 7579342751 |
| Mailing Telephone | (252) 338-3002 |
| Mailing Fax Number | 2523382902 |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2017-07-21 |
| Authorized Official Name | SYLVIA S MEADS (OFFICE MANAGER) |
| Authorized Official Telephone | 2523383002 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 335E00000X | Prosthetic/Orthotic Supplier | Suppliers | ||
| Y | 332BC3200X |
Durable Medical Equipment & Medical Supplies Specialization: Customized Equipment |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | BCBS | 384410 | 01 |
| VA | 9190511 | 05 | |
| NC | 7701327 | 05 | |
| NC | BCBS | 0482P | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912437930 | Coastal Carolina Prosthetics & Orthotics, Inc. | Prosthetist | 1970 W Arlington Blvd Ste A, Greenville, NC 27834-5783 | 2017-06-13 |
| 1790233385 | Coastal Carolina Prosthetics & Orthotics, Inc. | Durable Medical Equipment & Medical Supplies | 1715 Country Club Rd Ste B, Jacksonville, NC 28546-6042 | 2016-09-13 |
| 1386842193 | Coastal Carolina Prosthetics & Orthotics, Inc. | Durable Medical Equipment & Medical Supplies | 103 Nc Highway 42 W, Ahoskie, NC 27910-9725 | 2007-07-03 |
| 1124096292 | Coastal Carolina Prosthetics & Orthotics, Inc. | Durable Medical Equipment & Medical Supplies | 106 Medical Drive, Elizabeth City, NC 27909 | 2006-03-14 |
| 1710344304 | Coastal Carolina Prosthetics & Orthotics, Inc. | Prosthetic/Orthotic Supplier | 2800 Ashton Dr Ste 201, Wilmington, NC 28412-2486 | 2016-01-27 |
| 1659472926 | Coastal Carolina Prosthetics & Orthotics, Inc. | Durable Medical Equipment & Medical Supplies | 405 W 15th St, Washington, NC 27889-3524 | 2006-09-26 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | COASTAL CAROLINA PROSTHETICS & ORTHOTICS, INC. | 103 Nc Hwy 42 W, Ahoskie, NC 27910-9725 |
| Street Address |
148 BURNETTS WAY STE 104 |
| City | SUFFOLK |
| State | VA |
| Zip Code | 23434-6149 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235780255 | Chiquita Savage | Home Health | You 1st Healthcare, 112 West Washington Street Suite 502, Suffolk, VA 23434 | 2019-09-20 |
| 1912561713 | Revivication Counseling Services | Counselor | 814 Cripple Creek Lane, Suffolk, VA 23434 | 2019-04-26 |
| 1558826958 | Nita Jenkins | Non-emergency Medical Transport (VAN) | 707 Gittings St. Suite 105, Suffolk, VA 23434 | 2019-02-10 |
| 1730660952 | Latrese L Riddick | Driver | 418 Jackson St, Suffolk, VA 23434 | 2018-08-25 |
| 1114411279 | Percilla D Zeno | Community Health Worker | 102 Niblick Cir, Suffolk, VA 23434 | 2018-06-21 |
| 1437652765 | Aprele Gaddie | Health Educator | 2769 Godwin Boulevard, Suffolk, VA 23434 | 2018-03-13 |
| 1598284283 | Domonic Teheran Scott | Driver | 102 Brewer Ave, Suffolk, VA 23434 | 2017-09-13 |
| 1578089397 | Nakia Shantel Francis | Nurse Practitioner | 2970 Godwin Blvd, Suite 320, Suffolk, VA 23434 | 2017-08-15 |
| 1679093009 | Daisy Mae Aba, LLC | Behavioral Analyst | 3212 Clearcreek Rd., Suffolk, VA 23434 | 2017-06-27 |
| 1114457736 | Better Care Family Homes | Day Training, Developmentally Disabled Services | 813 West Washington Street, Suffolk, VA 23434 | 2017-06-15 |
| Find all providers in zip 23434 | ||||
| Taxonomy Code | 332BC3200X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| Specialization | Customized Equipment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669852620 | Hair Icon Prothisis Supply | Durable Medical Equipment & Medical Supplies | 6422 Aberdeen Pl, Suffolk, VA 23435-3039 | 2015-06-04 |
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| 1043849524 | Remote Health Solutions, LLC | Durable Medical Equipment & Medical Supplies | 15721 Wc Main St, Midlothian, VA 23113-7327 | 2020-04-06 |
| 1457983298 | Commonwealth Dental Sleep Medicine Inc | Durable Medical Equipment & Medical Supplies | 10601 Greenyard Way, Chester, VA 23831-1485 | 2020-02-10 |
| 1437610581 | Ainsley's Angels of America | Durable Medical Equipment & Medical Supplies | 828 Cabrini Place, Virginia Beach, VA 23464 | 2019-03-29 |
| 1154895449 | Xensan LLC | Durable Medical Equipment & Medical Supplies | 6547 Orland St, Falls Church, VA 22043-1813 | 2019-01-19 |
| 1851862940 | H. Charles Jelinek Jr. Dds | Durable Medical Equipment & Medical Supplies | 8505 Arlington Blvd Ste 260, Fairfax, VA 22031-4636 | 2018-12-16 |
| 1174099964 | Robin Melody Delbiondo | Durable Medical Equipment & Medical Supplies | 108 Ana Marie Blvd, Waynesboro, VA 22980-9607 | 2018-10-18 |
| 1366925398 | Mpower Me, LLC | Durable Medical Equipment & Medical Supplies | 73 Seven Ponds Rd, Amissville, VA 20106-4212 | 2018-09-14 |
| 1164909586 | 4k Tresses | Durable Medical Equipment & Medical Supplies | 1220 Executive Blvd Ste 101, Chesapeake, VA 23320 | 2018-07-27 |
| 1346736014 | Riverside Builders LLC | Durable Medical Equipment & Medical Supplies | 130 Swift Creek Ln, Colonial Heights, VA 23834-1631 | 2018-07-06 |
| Find all providers with the same taxonomy | ||||
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| 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.