Provider Demographics
NPI:1427565373
Name:THOME LEGACY ENTERPRISES LLC
Entity Type:Organization
Organization Name:THOME LEGACY ENTERPRISES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ISAIAH
Authorized Official - Middle Name:
Authorized Official - Last Name:WATHOME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-982-8008
Mailing Address - Street 1:85 SWANSON RD STE 110D
Mailing Address - Street 2:
Mailing Address - City:BOXBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01719-1300
Mailing Address - Country:US
Mailing Address - Phone:508-982-8008
Mailing Address - Fax:978-670-0299
Practice Address - Street 1:85 SWANSON RD STE 110D
Practice Address - Street 2:
Practice Address - City:BOXBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01719-1300
Practice Address - Country:US
Practice Address - Phone:508-982-8008
Practice Address - Fax:978-670-0299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-01
Last Update Date:2018-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347E00000XTransportation ServicesTransportation Broker