Provider Demographics
NPI:1750803243
Name:COASTAL HOUSE CALLS
Entity type:Organization
Organization Name:COASTAL HOUSE CALLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-286-5383
Mailing Address - Street 1:671 JAMESTOWN DR STE 203
Mailing Address - Street 2:
Mailing Address - City:MURRELLS INLET
Mailing Address - State:SC
Mailing Address - Zip Code:29576-7507
Mailing Address - Country:US
Mailing Address - Phone:843-286-5383
Mailing Address - Fax:843-286-5384
Practice Address - Street 1:671 JAMESTOWN DR STE 203
Practice Address - Street 2:
Practice Address - City:MURRELLS INLET
Practice Address - State:SC
Practice Address - Zip Code:29576-7507
Practice Address - Country:US
Practice Address - Phone:843-286-5383
Practice Address - Fax:843-286-5384
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric PsychiatryGroup - Multi-Specialty