Organization
LEGACY HOME CARE AGENCY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TRACY HASKINS (DIRECTOR)
(919) 693-1067
Entity
Organization
Contact information
Practice address
615B LEWIS ST, SUITE 106, OXFORD, NC 27565-3523
(919) 693-1067
(919) 693-1067
Mailing address
PO BOX 1814, OXFORD, NC 27565-1814
(919) 693-1067
(919) 693-1067
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
HC3574
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3418335
—
NC
05
—
7100597
—
NC
Enumeration date
07/02/2007
Last updated
08/22/2020
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