LEGACY COMPOUDING INC. (NPI# 1619481306) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619481306 |
| Entity Type | Organization |
| Organization Name | LEGACY COMPOUDING INC. |
| Practice Address |
2422 Danville Rd Sw Ste H Decatur AL 35603-4221 |
| Practice Telephone | 2563531123 |
| Practice Fax Number | 2562803551 |
| Mailing Telephone | 2563531123 |
| Mailing Fax Number | 2562803551 |
| Enumeration Date | 2017-11-17 |
| Last Update Date | 2018-06-16 |
| Authorized Official Name | MR. SAMUEL MARION COSTELLO (PRESIDENT/OWNER) |
| Authorized Official Telephone | 2563531123 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | 114750 | AL | Suppliers |
| Street Address |
2422 DANVILLE RD SW STE H |
| City | DECATUR |
| State | AL |
| Zip Code | 35603-4221 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144733072 | Legacy Compounding Inc | Durable Medical Equipment & Medical Supplies | 2422 Danville Rd Sw Ste H, Decatur, AL 35603-4221 | 2017-11-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043858848 | Marcanna Michele Kimball | Technician | 1616 Saginaw Ln Sw, Decatur, AL 35603 | 2019-12-12 |
| 1316503808 | Julie Monteiro-pai | Nurse Practitioner | 2828 Us 31, Suite # 117, Decatur, AL 35603 | 2019-05-10 |
| 1700305372 | Jessica Skarda | Nurse Practitioner | 1577-1631 Kathy Ln Sw, Decatur, AL 35603 | 2017-09-14 |
| 1841532546 | Priceville Pharmacy LLC | Pharmacy | 2941 Point Mallard Pkwy, Suite A, Decatur, AL 35603 | 2013-03-20 |
| 1235392689 | David Gerardo Barraza | Nurse Practitioner | 2422 Donville Road, Suite E, Decatur, AL 35603 | 2008-07-07 |
| 1164629002 | Rachel E. Kennedy | Family Medicine | 2422 Danville Rd., Suite E, Decatur, AL 35603 | 2007-07-02 |
| 1558583708 | Active Physical Therapy, Inc. | Clinic/Center | 2424 Danville Rd. Sw, Ste M, Decatur, AL 35603 | 2007-05-03 |
| 1598829814 | Decatur Eye Institute | Optometrist | 2620 Centron Dirve Sw, Decatur, AL 35603 | 2006-12-21 |
| 1447326442 | Joseph R Dupper | Podiatrist | 2506 Danville Rd Sw Suite 204, Decatur, AL 35603 | 2006-11-28 |
| 1568531820 | Highlands Internal Medicine LLC | Internal Medicine | 2422 Danville Rd, Suite F, Decatur, AL 35603 | 2006-11-08 |
| Find all providers in zip 35603 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720547532 | Unique Visions LLC | Durable Medical Equipment & Medical Supplies | 2948 Laguna Dr, Decatur, GA 30032-3526 | 2019-03-19 |
| 1164915427 | Premium Medical Supply LLC | Durable Medical Equipment & Medical Supplies | 3011 Rainbow Dr Ste 303, Decatur, GA 30034-1681 | 2018-06-12 |
| 1396241535 | Gre Days Corp | Durable Medical Equipment & Medical Supplies | 3013 Rainbow Dr Ste 124, Decatur, GA 30034-1644 | 2018-04-05 |
| 1144733072 | Legacy Compounding Inc | Durable Medical Equipment & Medical Supplies | 2422 Danville Rd Sw Ste H, Decatur, AL 35603-4221 | 2017-11-14 |
| 1063924397 | Publix Alabama LLC | Durable Medical Equipment & Medical Supplies | 2934 Point Mallard Pkwy Se, Decatur, AL 35603-5700 | 2017-10-26 |
| 1689186199 | Georgia Pain and Wellness Center | Durable Medical Equipment & Medical Supplies | 484 Irvin Ct Ste 110, Decatur, GA 30030-5406 | 2017-10-25 |
| 1558887497 | Decatur Medical Supplies | Durable Medical Equipment & Medical Supplies | 2107 N Decatur Rd Unit 832, Decatur, GA 30033-5305 | 2017-08-22 |
| 1972027456 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 4855 Flat Shoals Pkwy, Decatur, GA 30034-5208 | 2017-07-27 |
| 1508304411 | Comfort Medical Supplies | Durable Medical Equipment & Medical Supplies | 5055 Miller Woods Dr, Decatur, GA 30035-3751 | 2017-02-10 |
| 1225493851 | Pain Rehab Equipment | Durable Medical Equipment & Medical Supplies | 220 Ponce De Leon Pl, 172, Decatur, GA 30030-3233 | 2015-12-26 |
| Find all providers in DECATUR | ||||
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| 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.