Healthcare Provider Details

I. General information

NPI: 1861483687
Provider Name (Legal Business Name): LEGUM HOME HEALTH CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2005
Last Update Date: 04/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 EBCO CIR
WAYNESBORO VA
22980-7344
US

IV. Provider business mailing address

30 EBCO CIR
WAYNESBORO VA
22980-7344
US

V. Phone/Fax

Practice location:
  • Phone: 540-932-3000
  • Fax: 540-932-3018
Mailing address:
  • Phone: 540-932-3000
  • Fax: 540-932-3018

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number0201002399
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. LYNN HALE BRYSON
Title or Position: DIV PRESIDENT
Credential:
Phone: 301-353-0300