# LEGACY SPECIALTY PHARMACY CORP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1538713524
- **Authorized official:** MATTHEW SANGER (MANAGING MEMBER)
- **Authorized official phone:** (718) 456-7300

## Contact information

- **Practice address:** 6668 FRESH POND RD, RIDGEWOOD, NY 11385-3912
- **Practice address phone:** (718) 456-7300
- **Practice address fax:** (718) 456-7302
- **Mailing address:** 6851 FRESH POND RD \# 3STO, RIDGEWOOD, NY 11385-5296
- **Mailing address phone:** (718) 456-7300
- **Mailing address fax:** (718) 456-7302

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 333600000X | Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 07/28/2019
- **Last updated:** 09/09/2024