Healthcare Provider Details

I. General information

NPI: 1992612196
Provider Name (Legal Business Name): LEGACY CARE DME, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 FORBES BLVD STE 400
LANHAM MD
20706-6331
US

IV. Provider business mailing address

4500 FORBES BLVD STE 400 L-58
LANHAM MD
20706-6331
US

V. Phone/Fax

Practice location:
  • Phone: 301-710-5007
  • Fax: 207-703-7444
Mailing address:
  • Phone: 301-710-5007
  • Fax: 207-703-7444

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: JACQUELINE SMITH FOSTER
Title or Position: CEO
Credential:
Phone: 301-710-5007