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COASTAL PROSTHETIC & ORTHOTIC LABORATORY INC NPI 1720079262


NPI Information

NPI: 1720079262
Provider Name: COASTAL PROSTHETIC & ORTHOTIC LABORATORY INC
Classification: Prosthetic/Orthotic Supplier - 335E00000X
Entity Type: Organization
Address:
11871 PLAZA DRIVE
SUITE 6
MURRELLS INLET, SC
ZIP 29576
Phone: (843) 651-8570
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COASTAL PROSTHETIC & ORTHOTIC LABORATORY INC is a prosthetic orthotic supplier in Murrells Inlet, SC. The provider is an organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition. COASTAL PROSTHETIC & ORTHOTIC LABORATORY INC NPI is 1720079262. The provider is registered as an organization entity type.

The provider's business location address is:

11871 PLAZA DRIVE
SUITE 6
MURRELLS INLET, SC
ZIP 29576-351
Phone: (843) 651-8570
Fax: (843) 651-2461

The provider's authorized official is William C Vann .
The authorized official title is President and has the following contact phone number (843) 651-8570.

The enumeration date for this NPI number is 11/3/2005 and was last updated on 12/28/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1335E00000XProsthetic/Orthotic Supplier026218673SOUTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1557506MEDICAIDSOUTH CAROLINA
20193990001MEDICARE NSCSOUTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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