Provider Demographics
NPI:1881441046
Name:A LEGEND MEDICAL TRANSPORT LLC
Entity type:Organization
Organization Name:A LEGEND MEDICAL TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHNY
Authorized Official - Middle Name:
Authorized Official - Last Name:EUGENE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-281-9722
Mailing Address - Street 1:3993 SUNSET RD
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17112-3015
Mailing Address - Country:US
Mailing Address - Phone:267-317-4076
Mailing Address - Fax:412-810-8001
Practice Address - Street 1:3993 SUNSET RD
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17112-3015
Practice Address - Country:US
Practice Address - Phone:267-317-4076
Practice Address - Fax:412-810-8001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-03
Last Update Date:2024-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)