| Legacy Healthcare, Llc | |
|
2407 Ring Rd Ste 104 Elizabethtown KY 42701-5938 | |
| (270) 766-1902 | |
| (270) 737-7654 |
| Full Name | Legacy Healthcare, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 2407 Ring Rd Ste 104, Elizabethtown, Kentucky |
| Authorized Official Name and Position | Dana M Burrell (OWNER) |
| Authorized Official Contact | 2707661902 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Legacy Healthcare, Llc 2407 Ring Rd Ste 104 Elizabethtown KY 42701-5938 Ph: (270) 766-1902 | Legacy Healthcare, Llc 2407 Ring Rd Ste 104 Elizabethtown KY 42701-5938 Ph: (270) 766-1902 |
| NPI Number | 1558025908 |
|---|---|
| Provider Enumeration Date | 10/22/2021 |
| Last Update Date | 10/22/2021 |
| Medicare PECOS PAC ID | 1658760384 |
|---|---|
| Medicare Enrollment ID | O20211117002933 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558025908 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Amanda S Hendricks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679867014 PECOS PAC ID: 6901075803 Enrollment ID: I20110810000558 |
| Provider Name | Felicia Armstrong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124737390 PECOS PAC ID: 1355711664 Enrollment ID: I20230103001106 |
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