Provider Demographics
NPI:1588013163
Name:LAFAYETTE HEALTH VENTURES, INC
Entity Type:Organization
Organization Name:LAFAYETTE HEALTH VENTURES, INC
Other - Org Name:FAMILY HEALTH PLAZA SUGAR MILL POND DME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SVP
Authorized Official - Prefix:
Authorized Official - First Name:AL
Authorized Official - Middle Name:
Authorized Official - Last Name:PATIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-289-8951
Mailing Address - Street 1:121 AUDUBON BLVD
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503-2606
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2810 BONIN RD
Practice Address - Street 2:
Practice Address - City:YOUNGSVILLE
Practice Address - State:LA
Practice Address - Zip Code:70592-5600
Practice Address - Country:US
Practice Address - Phone:337-857-5765
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-06
Last Update Date:2016-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty