Healthcare Provider Details

I. General information

NPI: 1891859609
Provider Name (Legal Business Name): LEGUM HOME HEALTH CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 EBCO CIR SUITE 102
WAYNESBORO VA
22980-7344
US

IV. Provider business mailing address

30 EBCO CIR SUITE 102
WAYNESBORO VA
22980-7344
US

V. Phone/Fax

Practice location:
  • Phone: 540-932-3000
  • Fax: 540-932-3028
Mailing address:
  • Phone: 540-932-3000
  • Fax: 540-932-3028

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: GREG DEDRICK
Title or Position: DIRECTOR OF REIMBURSEMENT
Credential:
Phone: 540-932-3000