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Organization
HEALTH MART MEDICAL OF LAFAYETTE, L.L.C.
Active
Organization
HEALTH MART MEDICAL OF LAFAYETTE, L.L.C.
Active
Other names
Health Mart Medical
Organization subpart
No
Provider details
NPI number
Authorized official
WESLEY JAMES DAVID RPH (OWNER)
(337) 523-1851
Entity
Organization
Contact information
Practice address
1322 ELTON RD, STE A, JENNINGS, LA 70546-4100
(337) 523-1851
(337) 824-2057
Mailing address
1322 ELTON RD, STE A, JENNINGS, LA 70546-4100
(337) 523-1851
(337) 824-2057
Taxonomy
Speciality
Code
Description
License number
State
332BN1400X
Nursing Facility Supplies (DME)
DME.000155
LA
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
DME.000155
LA
Other
Enumeration date
08/17/2011
Last updated
07/17/2012
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