Provider Demographics
NPI:1124123625
Name:LAURANCE J LACHAT
Entity type:Organization
Organization Name:LAURANCE J LACHAT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:J
Authorized Official - Last Name:LACHAT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-493-7277
Mailing Address - Street 1:510 E WILLIAMS ST
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27502-2151
Mailing Address - Country:US
Mailing Address - Phone:800-493-7277
Mailing Address - Fax:800-824-9282
Practice Address - Street 1:510 E WILLIAMS ST
Practice Address - Street 2:
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27502-2151
Practice Address - Country:US
Practice Address - Phone:800-493-7277
Practice Address - Fax:800-824-9282
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2012-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0985230001332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7701515Medicaid
0985230001Medicare NSC