Provider Demographics
NPI:1972726412
Name:LAFAYETTE HEALTH VENTURES, INC DBA ADVANCED MEDICAL SUPPLIES & SERVICE
Entity Type:Organization
Organization Name:LAFAYETTE HEALTH VENTURES, INC DBA ADVANCED MEDICAL SUPPLIES & SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:HUVAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:227-289-8969
Mailing Address - Street 1:1010 COOLIDGE BLVD
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503-2436
Mailing Address - Country:US
Mailing Address - Phone:337-289-8929
Mailing Address - Fax:337-289-8928
Practice Address - Street 1:1010 COOLIDGE BLVD
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-2436
Practice Address - Country:US
Practice Address - Phone:337-289-8929
Practice Address - Fax:337-289-8928
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1184705Medicaid