Provider Demographics
NPI:1548449879
Name:TRI-COASTAL MANAGEMENT GROUP, INC
Entity type:Organization
Organization Name:TRI-COASTAL MANAGEMENT GROUP, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:DINEZ-CATRALLE
Authorized Official - Last Name:BARNES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-680-3013
Mailing Address - Street 1:PO BOX 2292
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23831-8444
Mailing Address - Country:US
Mailing Address - Phone:804-680-3013
Mailing Address - Fax:804-545-3901
Practice Address - Street 1:124 N FERN AVE
Practice Address - Street 2:
Practice Address - City:HIGHLAND SPRINGS
Practice Address - State:VA
Practice Address - Zip Code:23075-1441
Practice Address - Country:US
Practice Address - Phone:804-680-3013
Practice Address - Fax:804-545-3901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-02
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA171WH0202X, 171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Multi-Specialty
No171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Multi-Specialty