Healthcare Provider Details

I. General information

NPI: 1538133814
Provider Name (Legal Business Name): LAFAYETTE GENERAL MEDICAL CENTER INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2006
Last Update Date: 01/12/2023
Certification Date: 01/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2810 AMBASSADOR CAFFERY PKWY
LAFAYETTE LA
70506
US

IV. Provider business mailing address

1214 COOLIDGE BLVD
LAFAYETTE LA
70503-2621
US

V. Phone/Fax

Practice location:
  • Phone: 337-981-2949
  • Fax:
Mailing address:
  • Phone: 337-289-7374
  • Fax: 337-289-8671

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License Number207
License Number StateLA

VIII. Authorized Official

Name: PATRICK GANDY
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 337-289-7743