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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