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NPI Code Detail

MEDICARE: LHCG XLII, LLC

MEDICARE: LHCG XLII, LLC
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
1251J00000XNursing Care AgencyAR
2251E00000XHome Health Agency

General Provider Information

NPI Number : 1154668895
Entity Type Code : Organization
Provider Name (Legal Business Name) : LHCG XLII, LLC
Provider Business Mailing Address
First Line : PO BOX 51266
Second Line :
City : LAFAYETTE
State : LA
Zip : 70505-1266
Country : US
Telephone Number : 337-233-1307
Fax Number : 337-233-5764
Provider Business Practice Location Address
First Line : 2904 JENNY LIND RD STE 9A
Second Line :
City : FORT SMITH
State : AR
Zip : 72901-6735
Country : US
Telephone Number : 479-494-7273
Fax Number : 479-494-7387
Authorized Official
Title or Position : PRESIDENT
Name : JOSHUA L PROFFITT
Credential :
Telephone Number : 337-233-1307
Provider Enumeration Date : 01/15/2013
Last Update Date : 04/09/2024

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