Provider Demographics
NPI:1104102953
Name:COASTAL HELICOPTERS, INC.
Entity type:Organization
Organization Name:COASTAL HELICOPTERS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:H
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-789-5600
Mailing Address - Street 1:8995 YANDUKIN DR
Mailing Address - Street 2:
Mailing Address - City:JUNEAU
Mailing Address - State:AK
Mailing Address - Zip Code:99801-8086
Mailing Address - Country:US
Mailing Address - Phone:907-789-5600
Mailing Address - Fax:907-789-5528
Practice Address - Street 1:8995 YANDUKIN DR
Practice Address - Street 2:
Practice Address - City:JUNEAU
Practice Address - State:AK
Practice Address - Zip Code:99801-8086
Practice Address - Country:US
Practice Address - Phone:907-789-5600
Practice Address - Fax:907-789-5528
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-25
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKXCHA714S344800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344800000XTransportation ServicesAir Carrier
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKAL2558Medicaid
AKK0000RGCMKOtherPTAN