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Contact Information

J & R LAGRANGE, LLC
1012 RICHWOOD WAY
CRESTWOOD, KY40031-8930
 Phone: 502-222-3186
 Fax: 502-222-6535
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Skilled Nursing Facility

314000000X A1[8] Skilled Nursing Facility
 

Durable Medical Equipment & Medical Supplies

332B00000X 54 Other Medical Supply Company
 

Nursing Facility Supplies

332BN1400X 87 All Other Suppliers
 

Occupational Therapist

225X00000X 67 Occupational Therapist in Private Practice
 

Parenteral & Enteral Nutrition

332BP3500X 87 All Other Suppliers
 

Physical Therapist

225100000X 65 Physical Therapist in Private Practice
 

Prosthetic/Orthotic Supplier

335E00000X 51 Medical Supply Company with Orthotist
 

Speech-Language Pathologist

235Z00000X 15 Speech Language Pathologist
Indicates primary specialty

NPI Profile & details for J & R LAGRANGE, LLC

NPI Number 1700978806
LBN Legal business name J & R LAGRANGE, LLC
Authorized official MARK BOWMAN - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 09/28/2006
Last updated 06/24/2008 - About 18 years ago
Identifiers
KY License # 100818
KY Medicaid 12503413
KY Other 000000054853 ANTHEM BC/BS
KY Other 2702411000 PASSPORT ADVANTAGE
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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