Provider Demographics
NPI:1194101279
Name:LEGACY MEDICAL TRANSPORTATION
Entity type:Organization
Organization Name:LEGACY MEDICAL TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NADIA
Authorized Official - Middle Name:MANAZ
Authorized Official - Last Name:FRANCOIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-681-3510
Mailing Address - Street 1:22902 HUGHES RD
Mailing Address - Street 2:
Mailing Address - City:ZACHARY
Mailing Address - State:LA
Mailing Address - Zip Code:70791-6624
Mailing Address - Country:US
Mailing Address - Phone:225-681-3510
Mailing Address - Fax:
Practice Address - Street 1:4303 AIRLINE HWY
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70805-1502
Practice Address - Country:US
Practice Address - Phone:225-681-3510
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-30
Last Update Date:2015-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)