Provider Demographics
NPI:1700504388
Name:LEGACY MATTERS LLC
Entity Type:Organization
Organization Name:LEGACY MATTERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:MUJAHID
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAKUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-277-1447
Mailing Address - Street 1:146 COUNTRY CLUB DR
Mailing Address - Street 2:
Mailing Address - City:LANSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19446-1456
Mailing Address - Country:US
Mailing Address - Phone:215-989-3189
Mailing Address - Fax:
Practice Address - Street 1:261 OLD YORK RD STE 522
Practice Address - Street 2:
Practice Address - City:JENKINTOWN
Practice Address - State:PA
Practice Address - Zip Code:19046-3721
Practice Address - Country:US
Practice Address - Phone:215-277-1447
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-18
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care