Provider Demographics
NPI:1033551940
Name:PEK'S LEGACY HEALTHCARE, INCORPORATED
Entity Type:Organization
Organization Name:PEK'S LEGACY HEALTHCARE, INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:EUNICE
Authorized Official - Middle Name:
Authorized Official - Last Name:KOFFI
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:979-661-4485
Mailing Address - Street 1:102 E ALAMO ST
Mailing Address - Street 2:200 C
Mailing Address - City:BRENHAM
Mailing Address - State:TX
Mailing Address - Zip Code:77833-3792
Mailing Address - Country:US
Mailing Address - Phone:979-661-4485
Mailing Address - Fax:888-316-5492
Practice Address - Street 1:102 E ALAMO ST
Practice Address - Street 2:200 C
Practice Address - City:BRENHAM
Practice Address - State:TX
Practice Address - Zip Code:77833-3792
Practice Address - Country:US
Practice Address - Phone:979-661-4485
Practice Address - Fax:888-316-5492
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-19
Last Update Date:2014-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health