Healthcare Provider Details

I. General information

NPI: 1184529281
Provider Name (Legal Business Name): LIBERATOR MEDICAL SUPPLY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 S TAYLOR AVE STE 300
LOUISVILLE CO
80027-3076
US

IV. Provider business mailing address

321 S TAYLOR AVE STE 300
LOUISVILLE CO
80027-3076
US

V. Phone/Fax

Practice location:
  • Phone: 800-323-0914
  • Fax: 877-730-7796
Mailing address:
  • Phone: 800-323-0914
  • Fax: 877-730-7796

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateNULL

VIII. Authorized Official

Name: MICHAEL J BRESLIN
Title or Position: PRESIDENT / GENERAL MANAGER
Credential:
Phone: 800-323-0914