Provider Demographics
NPI:1427395565
Name:LEGACY MEDICAL TRANSPORT INC
Entity Type:Organization
Organization Name:LEGACY MEDICAL TRANSPORT INC
Other - Org Name:LEGACY AMBULANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARAGRITA
Authorized Official - Middle Name:
Authorized Official - Last Name:LAPUSNEANU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-792-4042
Mailing Address - Street 1:3021 FRANKS RD
Mailing Address - Street 2:SUITE 7
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006-4216
Mailing Address - Country:US
Mailing Address - Phone:267-709-7138
Mailing Address - Fax:
Practice Address - Street 1:3021 FRANKS RD
Practice Address - Street 2:SUITE 7
Practice Address - City:HUNTINGDON VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19006-4216
Practice Address - Country:US
Practice Address - Phone:267-709-7138
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-09
Last Update Date:2013-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA120453416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport