Legacy DME Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

LEGACY DME INC

Practice address

1111 Bayside Dr
Corona del Mar, CA 92625-1714

Phone

(714) 222-4600

NPI assigned

Mar 21, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Edward Kurtz

Title

Ceo

Phone

(714) 222-4600

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1553126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652659200000",
    "number": "1649730052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2015 AMBIE WAY",
            "city": "FAIRVIEW",
            "state": "TN",
            "postal_code": "370625006",
            "telephone_number": "714-222-4600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 BAYSIDE DR",
            "city": "CORONA DEL MAR",
            "state": "CA",
            "postal_code": "926251714",
            "telephone_number": "714-222-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY DME INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-21",
        "last_updated": "2022-05-16",
        "certification_date": "2022-05-16",
        "status": "A",
        "authorized_official_last_name": "KURTZ",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "714-222-4600"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Corona del Mar, CA
• Providers in Corona del Mar, CA by specialty
• Durable Medical Equipment & Medical Supplies in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.