| NPI | 1639747892 |
|---|---|
| Doing Business As | COASTAL RESPIRATORY AND BRACE STORE 2 |
| Entity Type | Organization |
| Authorized Contact | JONATHAN KYLE STURGEON CEO 843-665-4051 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies |
| Enumeration Date | 2021-06-15 |
| Last Update Date | 2021-06-15 |