Legendary Support Coordination, Llc

LBN: Legendary Support Coordination, Llc
Legendary Support Coordination, Llc is an health care organization with primary practice located at 4950 Parkside Ave Ste 102 , Philadelphia PA 19131-4700. The organization recently has only one registered license in Agencies / Hospice Care, Community Based, which is considered as the primary health care specialty. Legendary Support Coordination, Llc can be contacted via phone (215) 596-5940, or through Pettaway, James via phone (215) 596-5940.

Contact Information

Primary practice address
4950 Parkside Ave Ste 102 Philadelphia PA 19131-4700
Phone: (215) 596-5940
Fax: (215) 921-6188
Website:
Map and Directions
Authorized official contact:
Name: Pettaway, James
Phone: (215) 596-5940

Health care specialties

SpecialtyCodeLicense #State
Agencies / Hospice Care, Community Based 251G00000X Pennsylvania

Profile Details

NPI number 1346693496
LBN Legal business name Legendary Support Coordination, Llc
DBA Doing business as
Authorized official Pettaway, James
Entity Organization
Organization subpart 1 No
Enumeration date Jul 13th, 2016
Last updated Jul 13th, 2016 - about 9 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1346693496 NPPES
Pennsylvania MEDICAID 1030242230001
Pennsylvania MEDICAID 1030242230002

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