Legacy Mobile LLC

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

Legal business name

LEGACY MOBILE LLC

Practice address

4327 W Maldonado Rd
Laveen, AZ 85339-6227

Phone

(480) 349-0813

NPI assigned

Dec 9, 2024

Organization subpart

No

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

Authorized official

Name

Simon AmedaiNPI 1508611377

Title

Founder

Phone

(480) 349-0813

Specialties & licenses 2

Addresses

Other names 1

• Legacy Mobile Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Simon Amedai

  • Non-emergency Medical Transport (VAN)
  • Laveen, AZ
  • NPI 1508611377
  NPD Authorized official

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

{
    "created_epoch": "1733702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733702400000",
    "number": "1801602255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4327 W MALDONADO RD",
            "city": "LAVEEN",
            "state": "AZ",
            "postal_code": "853396227",
            "telephone_number": "480-349-0813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4327 W MALDONADO RD",
            "city": "LAVEEN",
            "state": "AZ",
            "postal_code": "853396227",
            "telephone_number": "480-349-0813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY MOBILE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-09",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A",
        "authorized_official_last_name": "AMEDAI",
        "authorized_official_first_name": "SIMON",
        "authorized_official_title_or_position": "FOUNDER",
        "authorized_official_telephone_number": "480-349-0813"
    },
    "taxonomies": [
        {
            "code": "343800000X",
            "taxonomy_group": "",
            "desc": "Secured Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Legacy Mobile",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Laveen Total Eyecare
• Karen Layaw
• Delia Ledesma, RN
• Gage Lee, DPT
• Tiffany Lee
• Legacy Wellness Homes LLC
• Betelhem Legese
• Leveen Family Eyecare
• Audra R Lewis, RDH
• Michael John Lewis, RPH

• Non-emergency Medical Transport (VAN) in Laveen, AZ
• Providers in Laveen, AZ by specialty
• Non-emergency Medical Transport (VAN) in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2024; 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.