MEDICAL LEGACY LLC (NPI# 1114189453) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114189453 |
| Entity Type | Organization |
| Organization Name | MEDICAL LEGACY LLC |
| Practice Address |
5310 Old Court Rd Suite 305 Randallstown MD 21133-5243 |
| Mailing Address |
5310 Old Court Rd Suite 305 Randallstown MA 21133 |
| Practice Telephone | 4106557100 |
| Practice Fax Number | 4106557917 |
| Mailing Telephone | 4106557100 |
| Mailing Fax Number | 4106557917 |
| Enumeration Date | 2008-06-27 |
| Last Update Date | 2008-06-27 |
| Authorized Official Name | OLUTOYIN A OKUNOREN (PRACTICE COORDINATOR) |
| Authorized Official Telephone | 4106557100 |
| Authorized Official Credential | RD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
D0023724 | MD | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | 255951000 | 05 |
| Street Address |
5310 OLD COURT RD SUITE 305 |
| City | RANDALLSTOWN |
| State | MD |
| Zip Code | 21133-5243 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518961598 | Eric Y Walker | Optometrist | 5310 Old Court Rd, Ste 103, Randallstown, MD 21133-5281 | 2005-06-08 |
| 1285245084 | Adore Health and Wellness | Social Worker | 5310 Old Court Rd, Randallstown, MD 21133-5243 | 2020-08-14 |
| 1235786658 | Andrea Nicole Randall | Social Worker | 5310 Old Court Rd, Randallstown, MD 21133-5243 | 2019-08-21 |
| 1265941900 | Donna M Saunders | Psychologist | 5310 Old Court Rd, Randallstown, MD 21133-5243 | 2017-09-26 |
| 1669847281 | Kingston C. Holcomb, Certified Counseling Associates, Inc. | Community/Behavioral Health | 5310 Old Court Rd, Randallstown, MD 21133-5243 | 2015-12-08 |
| 1811386626 | Steven Markow, Dds, PC | Clinic/Center | 5310 Old Court Rd, Suite 202, Randallstown, MD 21133-5243 | 2015-01-16 |
| 1023445103 | Raymonda Alfreda Adams | Social Worker | 5310 Old Court Rd, Suite 308 Office 1, Randallstown, MD 21133-5243 | 2013-10-03 |
| 1487937736 | Kingston Rashid Holcomb | Massage Therapist | 5310 Old Court Rd, Suite 308, Randallstown, MD 21133-5243 | 2011-09-23 |
| 1780977496 | Counselingworks LLC | Social Worker | 5310 Old Court Rd, Suite 308, Randallstown, MD 21133-5243 | 2011-05-27 |
| 1972802890 | Temitope S Williams | Nurse Practitioner | 5310 Old Court Rd, Randallstown, MD 21133-5243 | 2011-03-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649898313 | Olivia David | Registered Nurse | 3525 Liberty Resource Drive, Randallstown, MD 21133 | 2020-07-09 |
| 1366082547 | Jerry Njomgert Christopher | Home Health Aide | 9106 Sandra Ct. Randallstown, Randallstown, MD 21133 | 2020-01-15 |
| 1487138913 | For Hope's Sake, LLC | Substance Abuse Rehabilitation Facility | 9905 Southhall Road, Randallstown, MD 21133 | 2018-09-20 |
| 1295214393 | Levindale Hebrew Geriatric Center & Hospital Inc | Clinic/Center | Lifebridge Health Adult Day Services, 5400 Old Court Road, Randallstown, MD 21133 | 2018-08-09 |
| 1235623968 | Away of Change Counseling Service, LLC | Counselor | 5310 Old Court Rd Ste 304, Randallstown, MD 21133 | 2018-06-16 |
| 1922503382 | Top Care Residential Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 8607 Liberty Rd, Randallstown, MD 21133 | 2018-03-28 |
| 1497274880 | Yushika M Shepherd | In Home Supportive Care | 8911 Allenswood Rd, Randallstown, MD 21133 | 2017-09-17 |
| 1790208718 | Productive Lives Mental Health, LLC | Clinic/Center | Randallstown Medical Center 5310 Old Court Rd Suite 308, Randallstown, MD 21133 | 2017-07-21 |
| 1982136198 | Marla Rosanne Yee | Dentist | 5415 Old Court Road, Suite 01, Randallstown, MD 21133 | 2017-03-28 |
| 1598203549 | Traci Harris | Social Worker | 9633 Liberty Rd. (suites H&j), Randallstown, MD 21133 | 2017-02-09 |
| Find all providers in zip 21133 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548612799 | Mobile Np LLC | Clinic/Center | 3927 Mcdonogh Rd, Randallstown, MD 21133-3633 | 2016-07-11 |
| 1861689150 | Randallstown Primary Care, LLC | Clinic/Center | 5400 Old Court Rd, Suite 204, Randallstown, MD 21133-5100 | 2007-10-01 |
| 1326230343 | E.pasmanik, Md, LLC | Clinic/Center | 5400 Old Court Rd, Randallstown, MD 21133-5100 | 2007-08-14 |
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|---|---|---|---|---|
| 1316552219 | Premier Medical Care, LLC | Clinic/Center | 19735 Germantown Rd Ste 280, Germantown, MD 20874-1215 | 2020-09-09 |
| 1982226023 | Complete Access Care, LLC | Clinic/Center | 1035 Ingleside Ave, Catonsville, MD 21228-1318 | 2020-05-12 |
| 1184245045 | Comfort Primary Care | Clinic/Center | 9966 Royal Commerce Pl, Upper Marlboro, MD 20774-1163 | 2020-05-01 |
| 1407476955 | Rcc Community Services, Inc | Clinic/Center | 2628 Harford Rd, Baltimore, MD 21218-4928 | 2020-04-24 |
| 1013536960 | Philomena Nufunkuen Keli | Clinic/Center | 15012 Saddle Creek Dr, Burtonsville, MD 20866-2211 | 2020-04-10 |
| 1629606454 | Advanced Primary Care | Clinic/Center | 525 Eastern Ave # B2, Fairmount Heights, MD 20743-1677 | 2020-03-28 |
| 1588211890 | Two Tree Health Associates, LLC | Clinic/Center | 10 S Hanson St Ste 21, Easton, MD 21601-3078 | 2019-08-21 |
| 1427604099 | Ecarenow LLC | Clinic/Center | 176 Thomas Johnson Dr Ste 203, Frederick, MD 21702-4535 | 2019-08-09 |
| 1326691874 | Lotus Healthcare and Wellness LLC | Clinic/Center | 6495 New Hampshire Ave Ste B140, Hyattsville, MD 20783-3245 | 2019-07-23 |
| 1831750546 | Matobi Family Healthcare,llc | Clinic/Center | 7350 Van Dusen Rd Ste 340, Laurel, MD 20707-5264 | 2019-06-24 |
| Find all providers with the same taxonomy | ||||
| City | RANDALLSTOWN |
| Zip Code | 21133 |
Please comment or provide details below to improve the information on MEDICAL LEGACY LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.