Provider Demographics
NPI:1487888293
Name:LACAM ENTERPRISE LLC
Entity type:Organization
Organization Name:LACAM ENTERPRISE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:DERRICK
Authorized Official - Last Name:ELY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-925-9181
Mailing Address - Street 1:5258 DANTON PLACE
Mailing Address - Street 2:
Mailing Address - City:KEITHVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71047
Mailing Address - Country:US
Mailing Address - Phone:318-925-9181
Mailing Address - Fax:318-925-9180
Practice Address - Street 1:5258 DANTON PLACE
Practice Address - Street 2:
Practice Address - City:KEITHVILLE
Practice Address - State:LA
Practice Address - Zip Code:71047
Practice Address - Country:US
Practice Address - Phone:318-925-9181
Practice Address - Fax:318-925-9180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-07
Last Update Date:2009-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies