Provider Demographics
NPI:1144789579
Name:LEIGHCARE LLC
Entity Type:Organization
Organization Name:LEIGHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:WANGU
Authorized Official - Last Name:MAZODZE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-764-5094
Mailing Address - Street 1:5165 BROADWAY STE 282
Mailing Address - Street 2:
Mailing Address - City:DEPEW
Mailing Address - State:NY
Mailing Address - Zip Code:14043-4012
Mailing Address - Country:US
Mailing Address - Phone:646-764-5094
Mailing Address - Fax:
Practice Address - Street 1:17 ELKINS DR
Practice Address - Street 2:
Practice Address - City:CHEEKTOWAGA
Practice Address - State:NY
Practice Address - Zip Code:14225-2629
Practice Address - Country:US
Practice Address - Phone:646-764-5094
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-15
Last Update Date:2019-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)