Provider Demographics
NPI:1528245271
Name:USCG CLINIC CAPE MAY
Entity type:Organization
Organization Name:USCG CLINIC CAPE MAY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BERNARD
Authorized Official - Middle Name:
Authorized Official - Last Name:COFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:LT, USCG
Authorized Official - Phone:609-898-6860
Mailing Address - Street 1:1 MUNRO AVE
Mailing Address - Street 2:HEALTH SERVICES DIVISION
Mailing Address - City:CAPE MAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08204-5000
Mailing Address - Country:US
Mailing Address - Phone:609-898-6900
Mailing Address - Fax:609-898-6962
Practice Address - Street 1:1 MUNRO AVE
Practice Address - Street 2:HEALTH SERVICES DIVISION
Practice Address - City:CAPE MAY
Practice Address - State:NJ
Practice Address - Zip Code:08204-5000
Practice Address - Country:US
Practice Address - Phone:609-898-6900
Practice Address - Fax:609-898-6962
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:U. S. COAST GUARD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-01-24
Last Update Date:2008-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ261QM1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1100XAmbulatory Health Care FacilitiesClinic/CenterMilitary/U.S. Coast Guard Outpatient