Provider Demographics
NPI:1124771639
Name:LEGACY TRANSPORT SOLUTIONS LLC
Entity type:Organization
Organization Name:LEGACY TRANSPORT SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ONIKA
Authorized Official - Middle Name:T
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-274-7415
Mailing Address - Street 1:145 N CHURCH STREET STE 125 BOX 7
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29306
Mailing Address - Country:US
Mailing Address - Phone:864-274-7415
Mailing Address - Fax:864-586-1348
Practice Address - Street 1:145 N CHURCH ST STE 125
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29306-5123
Practice Address - Country:US
Practice Address - Phone:864-274-7415
Practice Address - Fax:864-586-1348
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-03
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies