Provider Demographics
NPI:1144893538
Name:COASTAL PATHWAYS LLC
Entity type:Organization
Organization Name:COASTAL PATHWAYS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARSHON
Authorized Official - Middle Name:MEGAL
Authorized Official - Last Name:ISAAC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-390-0731
Mailing Address - Street 1:14470 STONEGATE MANOR DR
Mailing Address - Street 2:
Mailing Address - City:GONZALES
Mailing Address - State:LA
Mailing Address - Zip Code:70737-7593
Mailing Address - Country:US
Mailing Address - Phone:225-390-0731
Mailing Address - Fax:
Practice Address - Street 1:14470 STONEGATE MANOR DR
Practice Address - Street 2:
Practice Address - City:GONZALES
Practice Address - State:LA
Practice Address - Zip Code:70737-7593
Practice Address - Country:US
Practice Address - Phone:225-390-0731
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-22
Last Update Date:2021-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)