Legacy Compouding Inc.

NPI #1619481306 in Decatur, Alabama

Provider Information

NPI Number: 1619481306
Entity Type: Organization
Organization Name: Legacy Compouding Inc.
Primary Specialty: Durable Medical Equipment & Medical Supplies
Enumeration Date: Nov 17, 2017
Last Updated: Jun 16, 2018

Practice Location

Address: 2422 DANVILLE RD SW STE H
City: Decatur
State: Alabama
ZIP Code: 35603-4221
Phone: (256) 353-1123

Authorized Official

Name: MR. SAMUEL MARION COSTELLO, RPH
Title: PRESIDENT/OWNER
Phone: (256) 353-1123

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Durable Medical Equipment & Medical Supplies	332B00000X	Primary

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