NPIMap

Organization Active NPI

Lafayette General Medical Center Inc.

Doing business as Lafayette General Medical Center Retail Pharmacy

  • Community/Retail Pharmacy
  • Lafayette, LA
National Provider Identifier
1023638715
Registry record updated Nov 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
LAFAYETTE GENERAL MEDICAL CENTER INC.
Doing business as
Lafayette General Medical Center Retail Pharmacy
Practice address
1214 Coolidge Blvd FL 1
Lafayette, LA 70503-2621
Phone
(337) 289-8812
Fax
(337) 289-8813
NPI assigned
Apr 22, 2020
Last updated
Nov 30, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
LAFAYETTE GENERAL MEDICAL CENTER INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 30, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Patrick W. Gandy
Title
Ceo
Phone
(337) 289-7743

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X NU Primary

Addresses

Primary practice location

1214 Coolidge Blvd FL 1
Lafayette, LA 70503-2621

Mailing address

PO Box 54287
New Orleans, LA 70154-4287
Phone (337) 289-8812

Other identifiers 1

IdentifierTypeStateIssuer
2207857MedicaidLA

Other names 1

  • Lafayette General Medical Center Retail Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210422001240 LA DME Supplier - Pharmacy 4688581457 Practice locations: Lafayette, LA

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Quickcare Evangeline7 organizations share this tax ID, including this one
Part of
Quickcare Evangeline

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Member organizations 17

Organizations listed as members of this organization in the National Provider Directory.

View all 17

Locations

1211 Coolidge Blvd
Ste 100
Lafayette, LA 70503
Phone (337) 234-5234

1214 Coolidge Blvd
Fl 1
Lafayette, LA 70503
Phone (337) 289-8812

134 Hospital Dr
Ste 101
Lafayette, LA 70503
Phone (337) 266-5592

134 Hospital Dr
Ste 201
Lafayette, LA 70503
Phone (337) 237-4843

134 Hospital Dr
Ste 202
Lafayette, LA 70503
Phone (337) 289-8282

136 Hospital Dr
Ste 100
Lafayette, LA 70503
Phone (337) 289-8282

136 Hospital Dr
Ste 101
Lafayette, LA 70503
Phone (337) 289-8282

Practitioners & affiliated clinicians

Practitioners 149

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 149

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1587513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638230400000",
    "number": "1023638715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 54287",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701544287",
            "telephone_number": "337-289-8812",
            "fax_number": "337-289-8813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1214 COOLIDGE BLVD FL 1",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705032621",
            "telephone_number": "337-289-8812",
            "fax_number": "337-289-8813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAFAYETTE GENERAL MEDICAL CENTER INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LAFAYETTE GENERAL MEDICAL CENTER INC",
        "enumeration_date": "2020-04-22",
        "last_updated": "2021-11-30",
        "certification_date": "2021-11-30",
        "status": "A",
        "authorized_official_last_name": "GANDY",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "337-289-7743",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2207857",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lafayette General Medical Center Retail Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lafayette, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.