Organization
ST. JOHN LEGACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PRESTON MAURICE ST. JOHN (OWNER)
(804) 617-7219
Entity
Organization
Contact information
Practice address
1452 COMMERCE RD, FARMVILLE, VA 23901-2749
(804) 617-7219
(434) 392-4084
Mailing address
1452 COMMERCE RD, FARMVILLE, VA 23901-2749
(804) 617-7219
(434) 392-4084
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
T67196902
VA
Other
Enumeration date
07/08/2016
Last updated
07/08/2016
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