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LEGENDARY SUPPORT COORDINATION, LLC
NPI 1346693496
Hospice Care, Community Based in Philadelphia, PA

Active since July 13, 2016
4950 PARKSIDE AVE STE 102, PHILADELPHIA, PA 19131(215) 596-5940(215) 921-6188 Get Directions Write a Review

NPPES record last updated: July 13, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Legendary Support Coordination, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LEGENDARY SUPPORT COORDINATION, LLC (NPI 1346693496) is a healthcare organization registered as a hospice care, community based in Philadelphia, Pennsylvania and active in the NPI registry since July 2016. The organization lists James Pettaway, Ceo, as its authorized official.

NPPES Registry Identity

NPI1346693496
Entity TypeOrganization
Primary Taxonomy251G00000X
Legal Business NameLEGENDARY SUPPORT COORDINATION, LLC
Location Address4950 PARKSIDE AVE STE 102Philadelphia, PA 19131-4700
Mailing Address4950 Parkside Ave Ste 102Philadelphia, PA 19131-4700 · (215) 596-5940 · Fax (215) 921-6188
Phone(215) 596-5940
Fax(215) 921-6188
Organization SubpartNo
Authorized OfficialJames PettawayCeo · (215) 596-5940
Enumeration DateJuly 13, 2016
✔ NPI 1346693496 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyHospice Care, Community BasedAgencies
Taxonomy Code251G00000X
4950 PARKSIDE AVE STE 102, Philadelphia, PA 19131
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Other Identifiers 2

Medicaid1030242230002PA
Medicaid1030242230001PA

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Legendary Support Coordination, LLC's NPI number?

The NPI number for Legendary Support Coordination, LLC is 1346693496. It was assigned to this organization in the NPPES registry on July 13, 2016.

Where is Legendary Support Coordination, LLC located?

Legendary Support Coordination, LLC is located at 4950 Parkside Ave Ste 102, Philadelphia, PA 19131. The listed phone number is (215) 596-5940.

What is Legendary Support Coordination, LLC's specialty?

The primary specialty registered for this NPI is Hospice Care, Community Based with taxonomy code 251G00000X.

When was this NPI record last updated?

The NPPES record for Legendary Support Coordination, LLC was last updated on July 13, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.