Organization
LAFAYETTE HEART HOSPITAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONALD J FENTEM (DIRECTOR BUSINESS OFFICE OPERATIONS)
(972) 702-7500
Entity
Organization
Contact information
Practice address
1105 KALISTE SALOOM RD, LAFAYETTE, LA 70508-5705
(337) 521-1017
(337) 521-1320
Mailing address
1105 KALISTE SALOOM RD, LAFAYETTE, TX 70508
(337) 521-1000
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
393491
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1703095
—
LA
01
—
60709
BLUE CROSS
LA
Enumeration date
07/14/2006
Last updated
10/09/2007
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