Organization
COASTAL ORTHOTICS AND PROSTHETICS LLC
Active
Parent organization
COASTAL ORTHOTICS AND PROSTHETICS LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
COASTAL ORTHOTICS AND PROSTHETICS LLC
Authorized official
MR. SEAN NORTHEY C.P./C.O.F. (OWNER)
(985) 626-1135
Entity
Organization
Contact information
Practice address
4600 HIGHWAY 22 STE 1, MANDEVILLE, LA 70471-2891
(985) 626-1135
(985) 626-1174
Mailing address
4600 HIGHWAY 22, STE 1, MANDEVILLE, LA 70471-2891
(985) 626-1135
(985) 626-1174
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06484500
—
MS
05
—
1116726
—
LA
01
—
G5261
BLUE CROSS/BLUE SHIELD
LA
Enumeration date
06/01/2005
Last updated
08/21/2025
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