Provider Demographics
NPI:1497466361
Name:THE LEGACY ROUTE, LLC
Entity Type:Organization
Organization Name:THE LEGACY ROUTE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:RENE
Authorized Official - Last Name:FISHER-BATES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-453-6717
Mailing Address - Street 1:609 METAIRIE RD # 8080
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70005-4034
Mailing Address - Country:US
Mailing Address - Phone:504-453-6717
Mailing Address - Fax:
Practice Address - Street 1:609 METAIRIE RD # 8080
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70005-4034
Practice Address - Country:US
Practice Address - Phone:504-453-6717
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-12
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)