Active NPI
Legacy Infusion Services, LLC
- Home Infusion Agency
- West Chester, OH
National Provider Identifier
1164741377
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Infusion Agency
- Legal business name
- LEGACY INFUSION SERVICES, LLC
- Practice address
- 9969 Cincinnati Dayton Rd
West Chester, OH 45069-3823 - Phone
- (937) 384-3873
- Fax
- (513) 942-2846
- NPI assigned
- May 27, 2010
- Last updated
- Mar 11, 2015
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. William S. Herdtner
- Title
- VP, Finance and Cfo
- Phone
- (513) 576-0262
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Infusion Agency | 251F00000X | NU | Primary | |
| Home Infusion Therapy Pharmacy | 3336H0001X | 022051200 | OH |
Addresses
Primary practice location
9969 Cincinnati Dayton Rd
West Chester, OH 45069-3823
Mailing address
1700 Edison Dr
Suite 300
Milford, OH 45150-2729
Phone (513) 576-0262
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3134101 | Medicaid | OH |
National Provider Directory
National Provider DirectoryMember of 3
Organizations this organization is a member of, according to the National Provider Directory.
-
dba Collaborative Pharmacy Services
- Long Term Care Pharmacy
- Miamisburg, OH
- NPI 1205005063
Member Of
Locations
1700 Edison Dr
Milford, OH 45150
9969 Cincinnati Dayton Rd
West Chester, OH 45069
Phone (937) 384-3873
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1274918400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1426032000000",
"number": "1164741377",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1700 EDISON DR",
"address_2": "SUITE 300",
"city": "MILFORD",
"state": "OH",
"postal_code": "451502729",
"telephone_number": "513-576-0262",
"fax_number": "513-576-0379"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9969 CINCINNATI DAYTON RD",
"city": "WEST CHESTER",
"state": "OH",
"postal_code": "450693823",
"telephone_number": "937-384-3873",
"fax_number": "513-942-2846"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LEGACY INFUSION SERVICES, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2010-05-27",
"last_updated": "2015-03-11",
"status": "A",
"authorized_official_last_name": "HERDTNER",
"authorized_official_first_name": "WILLIAM",
"authorized_official_middle_name": "S.",
"authorized_official_title_or_position": "VP, FINANCE AND CFO",
"authorized_official_telephone_number": "513-576-0262",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "251F00000X",
"taxonomy_group": "",
"desc": "Home Infusion",
"state": "NU",
"license": null,
"primary": true
},
{
"code": "3336H0001X",
"taxonomy_group": "",
"desc": "Pharmacy, Home Infusion Therapy Pharmacy",
"state": "OH",
"license": "022051200",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3134101",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in West Chester, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.