Organization
LEGACY MEDICAL SUPPLY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL GOMEZ (OWNER)
(954) 932-0069
Entity
Organization
Contact information
Practice address
10101 W SAMPLE RD STE 108, CORAL SPRINGS, FL 33065-3907
(954) 932-0069
(954) 932-0068
Mailing address
10101 W SAMPLE RD STE 108, CORAL SPRINGS, FL 33065-3907
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
01/21/2020
Last updated
07/27/2020
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