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Organization

LEGACY MEDICAL NETWORK LLC

Active
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Organization

LEGACY MEDICAL NETWORK LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOSEPH KONIKA (PRESIDENT)
(614) 458-8283
Entity
Organization

Contact information

Practice address
5797 BEECHCROFT RD STE F, COLUMBUS, OH 43229-2758
(614) 377-0268
Mailing address
5797 BEECHCROFT RD STE F, COLUMBUS, OH 43229-2758

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
—
—
261Q00000X
Clinic/Center
—
—
261QH0100X
Health Service Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
—
—
261QS1000X
Student Health Clinic/Center
—
—
261QU0200X
Urgent Care Clinic/Center
—
—
363L00000X
Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
Primary
—
—

Other

Enumeration date
04/04/2019
Last updated
06/11/2019
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