| Coastal Care Inc | |
|
1405 Alice St Waycross GA 31501-4528 | |
| (912) 285-8822 | |
| (912) 490-4870 |
| Full Name | Coastal Care Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1405 Alice St, Waycross, Georgia |
| Authorized Official Name and Position | Warren S Theis (OWNER) |
| Authorized Official Contact | 9122858822 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Coastal Care Inc 1405 Alice St Waycross GA 31501-4528 Ph: (912) 285-8822 | Coastal Care Inc 1405 Alice St Waycross GA 31501-4528 Ph: (912) 285-8822 |
| NPI Number | 1538367149 |
|---|---|
| Provider Enumeration Date | 07/05/2007 |
| Last Update Date | 07/01/2024 |
| Medicare PECOS PAC ID | 8921062498 |
|---|---|
| Medicare Enrollment ID | O20041115000734 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538367149 | NPI | - | NPPES |
| 672694005A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 055345 (Georgia) | Secondary |
| 261QP2300X | Clinic/center - Primary Care | 055345 (Georgia) | Primary |
| Provider Name | Warren S Theis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588658702 PECOS PAC ID: 3274598479 Enrollment ID: I20041130000505 |
| Provider Name | Tierra Carter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720619554 PECOS PAC ID: 0840686465 Enrollment ID: I20220407002530 |
David H. Cheatham, M.d.,p.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 801 Beacon St, Waycross, GA 31501 Phone: 912-285-2440 Fax: 912-287-0197 | |
Southeast Georgia Primary Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 409 Uvalda St, Waycross, GA 31501 Phone: 912-283-1359 Fax: 912-283-1362 | |
Peter Wrobel Md Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1720 Old Reynolds St, Waycross, GA 31501 Phone: 912-283-1359 Fax: 912-283-1360 | |
Thornton Family Chiropractic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 401 Stephenson St, Waycross, GA 31501 Phone: 912-283-6043 Fax: 912-283-6043 | |
Southeast Internal Medicine Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 406 Riverside Dr, Waycross, GA 31501 Phone: 912-287-1555 | |
Packer Medical Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 709 Knight Ave, Waycross, GA 31501 Phone: 912-283-2311 Fax: 912-283-8204 | |
Satilla Family Medicine, P.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 407 W Oneida St, Waycross, GA 31501 Phone: 912-338-0065 Fax: 912-338-0920 |