Provider Demographics
NPI:1972495968
Name:COASTAL CARE HEALTH NETWORK LLC
Entity type:Organization
Organization Name:COASTAL CARE HEALTH NETWORK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MELOGRANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-206-3699
Mailing Address - Street 1:3761 RENEE DR SUITE 22A PMB 300
Mailing Address - Street 2:AMANDA.MELOGRANO@GMAIL.COM
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29579-2957
Mailing Address - Country:US
Mailing Address - Phone:856-206-3699
Mailing Address - Fax:
Practice Address - Street 1:896 WATERBRIGE BLVD
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29579
Practice Address - Country:US
Practice Address - Phone:856-206-3699
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-16
Last Update Date:2025-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care