Basic Information
Provider Information
NPI: 1225628977
EntityType: 2
ReplacementNPI:  
OrganizationName: LHCG CXC, LLC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
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Mailing Information
Address1: PO BOX 51266
Address2:  
City: LAFAYETTE
State: LA
PostalCode: 705051266
CountryCode: US
TelephoneNumber: 3372331307
FaxNumber:  
Practice Location
Address1: 6019 WALNUT GROVE RD
Address2:  
City: MEMPHIS
State: TN
PostalCode: 381202113
CountryCode: US
TelephoneNumber: 9012264200
FaxNumber: 9012261460
Other Information
ProviderEnumerationDate: 01/26/2021
LastUpdateDate: 01/26/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: GACHASSIN
AuthorizedOfficialFirstName: NICHOLAS
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: SECRETARY/TREASURER
AuthorizedOfficialTelephone: 3372331307
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix: III
AuthorizedOfficialCredential:  
NPICertificationDate: 01/26/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
282E00000X  Y HospitalsLong Term Care Hospital 

No ID Information.


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