Provider Demographics
NPI:1902138332
Name:COGGINS, CHARLES STEPHEN
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:STEPHEN
Last Name:COGGINS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:784 NELSON DR
Mailing Address - Street 2:
Mailing Address - City:MURRELLS INLET
Mailing Address - State:SC
Mailing Address - Zip Code:29576-6304
Mailing Address - Country:US
Mailing Address - Phone:843-251-6843
Mailing Address - Fax:
Practice Address - Street 1:784 NELSON DR
Practice Address - Street 2:
Practice Address - City:MURRELLS INLET
Practice Address - State:SC
Practice Address - Zip Code:29576-6304
Practice Address - Country:US
Practice Address - Phone:843-251-6843
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-10
Last Update Date:2010-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies