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NPI Code Detail

MEDICARE: LEGACY HEALTHCARE SERVICES, INC

MEDICARE: LEGACY HEALTHCARE SERVICES, 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
1225X00000XOccupational Therapist
2235Z00000XSpeech-Language Pathologist
3225100000XPhysical Therapist

General Provider Information

NPI Number : 1174997233
Entity Type Code : Organization
Provider Name (Legal Business Name) : LEGACY HEALTHCARE SERVICES, INC
Provider Business Mailing Address
First Line : 3001 SPRING FOREST RD
Second Line :
City : RALEIGH
State : NC
Zip : 27616-2815
Country : US
Telephone Number : 919-424-5080
Fax Number : 919-431-9224
Provider Business Practice Location Address
First Line : 3420 WAKE FOREST RD
Second Line :
City : DURHAM
State : NC
Zip : 27703-3522
Country : US
Telephone Number : 919-957-8480
Fax Number : 919-957-8420
Authorized Official
Title or Position : CEO
Name : SANDRA M HOSKINS
Credential :
Telephone Number : 919-424-5081
Provider Enumeration Date : 11/30/2015
Last Update Date : 11/30/2015

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Directions to “LEGACY HEALTHCARE SERVICES, INC ” Practice Location

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