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NPI Code Detail

MEDICARE: LAFAYETTE LTC, INC

MEDICARE: LAFAYETTE LTC, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility185MS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1124135827
Entity Type Code : Organization
Provider Name (Legal Business Name) : LAFAYETTE LTC, INC
Provider Business Mailing Address
First Line : 1301 BELK BLVD
Second Line :
City : OXFORD
State : MS
Zip : 38655-5301
Country : US
Telephone Number : 662-234-7821
Fax Number : 662-234-0294
Provider Business Practice Location Address
First Line : 1301 BELK BLVD
Second Line :
City : OXFORD
State : MS
Zip : 38655-5301
Country : US
Telephone Number : 662-234-7821
Fax Number : 662-234-0294
Authorized Official
Title or Position : OWNER
Name : MR. GENE BENNETT HUBBARD JR.
Credential :
Telephone Number : 601-849-2294
Provider Enumeration Date : 08/25/2006
Last Update Date : 01/15/2015

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Directions to “LAFAYETTE LTC, INC ” Practice Location

Language Start Address Practice Location
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