Provider Demographics
NPI:1447330246
Name:UNITIED STATES COAST GUARD
Entity type:Organization
Organization Name:UNITIED STATES COAST GUARD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TECHNICIAN
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:FLORES
Authorized Official - Suffix:
Authorized Official - Credentials:HS
Authorized Official - Phone:609-898-6864
Mailing Address - Street 1:1410 DELAWARE AVE APT C
Mailing Address - Street 2:
Mailing Address - City:CAPE MAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08204-4037
Mailing Address - Country:US
Mailing Address - Phone:609-898-3368
Mailing Address - Fax:
Practice Address - Street 1:2100 2ND ST SW COMDT (CG-1122)
Practice Address - Street 2:SUITE 5314 US COAST GUARD
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20593
Practice Address - Country:US
Practice Address - Phone:609-898-6610
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherGroup - Multi-Specialty