Provider Demographics
NPI:1427423805
Name:COASTAL HEALTH DISTRICT 9-1
Entity type:Organization
Organization Name:COASTAL HEALTH DISTRICT 9-1
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF ADMINISTRATIVE SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:SWICEGOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-262-3063
Mailing Address - Street 1:150 SCRANTON CONNECTOR
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31525-0540
Mailing Address - Country:US
Mailing Address - Phone:912-262-2347
Mailing Address - Fax:912-262-3036
Practice Address - Street 1:150 SCRANTON CONNECTOR
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31525-0540
Practice Address - Country:US
Practice Address - Phone:912-262-2347
Practice Address - Fax:912-262-3036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-10
Last Update Date:2015-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare