MEDICARE: LEGACY MOBILITY SERVICES

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
1	246RP1900X	Phlebotomy Technician

General Provider Information

NPI Number	:	1356284558
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEGACY MOBILITY SERVICES

Provider Business Mailing Address
First Line	:	2849 MACKIN RD
Second Line	:
City	:	FLINT
State	:	MI
Zip	:	48504-7541
Country	:	US
Telephone Number	:	810-207-1037
Fax Number	:	810-674-2196

Provider Business Practice Location Address
First Line	:	2849 MACKIN RD
Second Line	:
City	:	FLINT
State	:	MI
Zip	:	48504-7541
Country	:	US
Telephone Number	:	810-207-1037
Fax Number	:	810-674-2196

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	MS. JAMEISHA SHELTON
Credential	:
Telephone Number	:	810-207-1037

Provider Enumeration Date	:	04/13/2026
Last Update Date	:	04/13/2026

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