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NPI Code Detail

MEDICARE: LEGACY CARE, INC.

MEDICARE: LEGACY CARE, INC.
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
1310400000XAssisted Living FacilityHAL025030NC

General Provider Information

NPI Number : 1407177603
Entity Type Code : Organization
Provider Name (Legal Business Name) : LEGACY CARE, INC.
Provider Business Mailing Address
First Line : PO BOX 1189
Second Line :
City : NEW BERN
State : NC
Zip : 28563-1189
Country : US
Telephone Number : 252-633-1143
Fax Number : 252-633-0422
Provider Business Practice Location Address
First Line : 3407 OAKS RD
Second Line :
City : NEW BERN
State : NC
Zip : 28560-2718
Country : US
Telephone Number : 252-633-1143
Fax Number : 252-633-0422
Authorized Official
Title or Position : PRESIDENT
Name : HARRY EDWARDS
Credential :
Telephone Number : 252-633-1143
Provider Enumeration Date : 06/22/2010
Last Update Date : 06/22/2010

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Directions to “LEGACY CARE, INC. ” Practice Location

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