MEDICARE: LEGACY HEALTHCARE SOLUTIONS 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
1	251E00000X	Home Health Agency
2	251J00000X	Nursing Care Agency

General Provider Information

NPI Number	:	1568102424
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEGACY HEALTHCARE SOLUTIONS INC.

Provider Business Mailing Address
First Line	:	3995 COTTAGE HILL RD STE B
Second Line	:
City	:	MOBILE
State	:	AL
Zip	:	36609-8419
Country	:	US
Telephone Number	:	251-709-0103
Fax Number	:

Provider Business Practice Location Address
First Line	:	3995 COTTAGE HILL RD STE B
Second Line	:
City	:	MOBILE
State	:	AL
Zip	:	36609-8419
Country	:	US
Telephone Number	:	251-709-0103
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	HALEY COAKER MASON
Credential	:
Telephone Number	:	251-709-0103

Provider Enumeration Date	:	03/30/2022
Last Update Date	:	03/30/2022

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