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Organization

LEGACY MEDICAL SUPPLY LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOVELYN MARIE PEDRO RAMENTO BSN, RN (OWNER / GENERAL MANAGER)
(808) 330-9508
Entity
Organization

Contact information

Practice address
98-138 HILA PL # PA05, PEARL CITY, HI 96782-3201
(808) 312-1632
(808) 312-4205
Mailing address
98-138 HILA PL # PA05, PEARL CITY, HI 96782-3201
(808) 312-1632
(808) 312-4205

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
HI

Other

Enumeration date
07/05/2017
Last updated
07/21/2022
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