Provider Demographics
NPI:1982446340
Name:COAST TO COAST SLEEP PC
Entity type:Organization
Organization Name:COAST TO COAST SLEEP PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:EATMON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:631-374-3410
Mailing Address - Street 1:2437 ROCKVILLE CENTRE PKWY
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11572-1622
Mailing Address - Country:US
Mailing Address - Phone:516-640-7401
Mailing Address - Fax:
Practice Address - Street 1:2931 GREY MOSS PASS
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30097-6274
Practice Address - Country:US
Practice Address - Phone:631-374-3410
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-07
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental