Organization
LEGACY CORE HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPHINE EBOMOYI (MANAGER)
(970) 397-8140
Entity
Organization
Contact information
Practice address
9415 S WESTERN AVE STE 235, CHICAGO, IL 60643-6700
(708) 321-1233
Mailing address
9415 S WESTERN AVE STE 235, CHICAGO, IL 60643-6700
(708) 321-1233
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
07/07/2022
Last updated
07/20/2022
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