LEGACY HOSPICE LLC NPI 1033238241

NPI Information

NPI: 1033238241
Provider Name: LEGACY HOSPICE, LLC
Classification: Hospice Care, Community Based - 251G00000X
Entity Type: Organization

CLIA Number: 04D1028945

Address:
901 WEST KEISER AVE
OSCEOLA, AR
ZIP 72370
Phone: (870) 563-9995
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LEGACY HOSPICE, LLC is a hospice care community based in Osceola, AR. LEGACY HOSPICE, LLC NPI is 1033238241. The provider is registered as an organization entity type.

The provider's business location address is:

901 WEST KEISER AVE
OSCEOLA, AR
ZIP 72370
Phone: (870) 563-9995
Fax: (870) 563-8455

The provider's authorized official is Lewis Clark Blair .
The authorized official title is Ceo and has the following contact phone number (205) 652-6167.

The CLIA number assigned to this NPI record is 04D1028945 - hospice with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/28/2007 and was last updated on 7/26/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	251G00000X	Hospice Care, Community Based		AR4223	ARKANSAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	11568	OTHER	ARKANSAS	BCBS PROVIDER #
2	154572747	MEDICAID	ARKANSAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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