Provider Demographics
NPI:1942835442
Name:LEGACY TRANSPORTATION GROUP
Entity type:Organization
Organization Name:LEGACY TRANSPORTATION GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DALEONE
Authorized Official - Middle Name:
Authorized Official - Last Name:PEOPLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-344-9696
Mailing Address - Street 1:574 E CUYAHOGA FALLS AVE UNIT 4946
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44310-1591
Mailing Address - Country:US
Mailing Address - Phone:330-344-9696
Mailing Address - Fax:
Practice Address - Street 1:762 EASTLAND AVENUE
Practice Address - Street 2:SUITE 170
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44305
Practice Address - Country:US
Practice Address - Phone:330-344-9696
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-05
Last Update Date:2020-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)