MEDICARE: LEGACY OXYGEN AND HOME CARE EQUIPMENT LLC

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	332BX2000X	Oxygen Equipment & Supplies (DME)

General Provider Information

NPI Number	:	1598808727
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEGACY OXYGEN AND HOME CARE EQUIPMENT LLC

Provider Business Mailing Address
First Line	:	924 S 12TH ST
Second Line	:
City	:	MURRAY
State	:	KY
Zip	:	42071-2949
Country	:	US
Telephone Number	:	270-442-7887
Fax Number	:	270-442-7897

Provider Business Practice Location Address
First Line	:	924 S 12TH ST
Second Line	:
City	:	MURRAY
State	:	KY
Zip	:	42071-2949
Country	:	US
Telephone Number	:	270-753-2001
Fax Number	:	270-753-2002

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL
Name	:	MR. GREG CRAWFORD
Credential	:
Telephone Number	:	859-441-8876

Provider Enumeration Date	:	02/15/2007
Last Update Date	:	12/16/2019

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