Provider Demographics
NPI:1477280840
Name:LEGACY EMS, INC.
Entity Type:Organization
Organization Name:LEGACY EMS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AR SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:KENNEDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-623-0056
Mailing Address - Street 1:PO BOX 527
Mailing Address - Street 2:
Mailing Address - City:MELVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71353-0527
Mailing Address - Country:US
Mailing Address - Phone:337-623-0056
Mailing Address - Fax:337-623-4789
Practice Address - Street 1:712 CLARK PL
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80915-4119
Practice Address - Country:US
Practice Address - Phone:337-623-0056
Practice Address - Fax:337-623-4789
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-04
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport