COASTAL COMMUNITY HEALTH SERVICES, INC. – NPI #1811602378
Clinic/Center

COASTAL COMMUNITY HEALTH SERVICES, INC. is an AHC clinic located in SAINT MARYS, GA. NPPES has assigned the NPI number 1811602378 to COASTAL COMMUNITY HEALTH SERVICES, INC. on January 19, 2023. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QF0400X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Federally Qualified Health Center (FQHC)

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for COASTAL COMMUNITY HEALTH SERVICES, INC. below.

NPI Profile for
COASTAL COMMUNITY HEALTH SERVICES, INC.

NPI Number
1811602378
Enumeration Date

(more than 3 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
COASTAL COMMUNITY HEALTH SERVICES, INC.
Primary location
202 LAKESHORE DR
SAINT MARYS, GA 31558-3876
Phone: (912) 275-8028 Fax:
Mailing address
100 PROFESSIONAL CENTER DR
BRUNSWICK, GA 31525-6743
Phone: (912) 275-8028 Fax:
Organization Subpart
No
Authorized Official
KAVANAUGH CHANDLER
CEO
Phone: (912) 275-8028
Updated
Certification Date
Jan 19, 2023

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QF0400X
- Clinic/Center / Federally Qualified Health Center (FQHC) (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.

Endpoint

Health Information Exchange (HEI)

HEI is the mobilization of health care information electronically across organizations within a region, community or hospital system. Endpoints provide a simple and secure way for participants to send authenticated, encrypted health information directly to known, trusted recipients over the internet such as primary care physicians, specialists, hospitals, labs, etc.

Endpoint
eClinicalWorks
Endpoint type
CONNECT URL
Endpoint Description
EMR
Content Type
OTHER
Affiliation
N
Endpoint Location
202 LAKESHORE DR,
SAINT MARYS, GA 77025-1669