Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Oxygen Equipment & Supplies |
332BX2000X | B1 | Oxygen supplier | |
Nursing Facility Supplies |
332BN1400X | 87 | All Other Suppliers |
| NPI # | 1376823716 |
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| LBN Legal business name | HEALTH MART MEDICAL OF LAFAYETTE, L.L.C. | ||||
| Authorized official | WESLEY DAVID - (OWNER) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | No | ||||
| Enumeration date | 08/17/2011 | ||||
| Last updated | 07/17/2012 - About 14 years ago | ||||
| Identifiers |
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