OrganizationCoastal Medical Transport, IncAmbulanceTransportation ServicesPractice Address101 S Granville St, Windsor, NC 27983-2148(252) 794-4149PECOS EnrollmentBased on the most recent information from CMS, provider Coastal Medical Transport, Inc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1104977198Provider TypeOrganizationFull NameCoastal Medical Transport, IncSubpartNoEnumeration Date1/16/2007Last Updated4/4/2008Contact InformationPractice LocationPractice Address101 S Granville St, Windsor, NC 27983-2148Phone(252) 794-4149Fax(252) 794-3477Mailing LocationMailing Address101 S Granville St, Windsor, NC 27983-2148Phone(252) 794-4149Fax(252) 794-3477Authorized OfficialNameBazemore, Tim (Owner)Phone(252) 794-4149Provider TaxonomiesCodeDescriptionLicenseCode3416L0300XPrimaryDescriptionAmbulanceTransportation ServicesLicense1556North CarolinaProvider IdentifiersIDDescriptionIssuerID0729RDescriptionOtherIssuerBLUECROSS BLUE SHIELDNorth CarolinaID3406822DescriptionMedicaidIssuerUnlistedNorth Carolina