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LEGACY HOME CARE AGENCY NPI 1952508939


NPI Information

NPI: 1952508939
Provider Name: LEGACY HOME CARE AGENCY
Classification: Licensed Practical Nurse - 164W00000X
Entity Type: Organization
Address:
615B LEWIS ST
SUITE 106
OXFORD, NC
ZIP 27565
Phone: (919) 693-1067
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LEGACY HOME CARE AGENCY is a licensed practical nurse in Oxford, NC. The provider is a licensed practical nurse with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. LEGACY HOME CARE AGENCY NPI is 1952508939. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

615B LEWIS ST
SUITE 106
OXFORD, NC
ZIP 27565-523
Phone: (919) 693-1067
Fax: (919) 693-1067

The provider's authorized official is Tracy Haskins .
The authorized official title is Director and has the following contact phone number (919) 693-1067.

The enumeration date for this NPI number is 7/2/2007 and was last updated on 8/22/2020.


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
1164W00000XLicensed Practical NurseHC3574NORTH CAROLINAYes

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
17100597MEDICAIDNORTH CAROLINA
23418335MEDICAIDNORTH CAROLINA

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: 5/5/2024

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