Provider Demographics
NPI:1861483687
Name:LEGUM HOME HEALTH CARE INC
Entity type:Organization
Organization Name:LEGUM HOME HEALTH CARE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIV PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:HALE
Authorized Official - Last Name:BRYSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-353-0300
Mailing Address - Street 1:30 EBCO CIR
Mailing Address - Street 2:
Mailing Address - City:WAYNESBORO
Mailing Address - State:VA
Mailing Address - Zip Code:22980-7344
Mailing Address - Country:US
Mailing Address - Phone:540-932-3000
Mailing Address - Fax:540-932-3018
Practice Address - Street 1:30 EBCO CIR
Practice Address - Street 2:
Practice Address - City:WAYNESBORO
Practice Address - State:VA
Practice Address - Zip Code:22980-7344
Practice Address - Country:US
Practice Address - Phone:540-932-3000
Practice Address - Fax:540-932-3018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-01
Last Update Date:2015-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0201002399333600000X
3336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0201002399OtherBOARD OF PHARMACY
VA0201002399OtherBOARD OF PHARMACY