Organization
LEGENDARY SUPPORT COORDINATION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES PETTAWAY (CEO)
(215) 596-5940
Entity
Organization
Contact information
Practice address
4950 PARKSIDE AVE STE 102, PHILADELPHIA, PA 19131-4700
(215) 596-5940
(215) 921-6188
Mailing address
4950 PARKSIDE AVE STE 102, PHILADELPHIA, PA 19131-4700
(215) 596-5940
(215) 921-6188
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1030242230001
—
PA
05
—
1030242230002
—
PA
Enumeration date
07/13/2016
Last updated
07/13/2016
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us