Healthcare Provider Details

I. General information

NPI: 1174920300
Provider Name (Legal Business Name): LIBERTY MEDICAL CARE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2014
Last Update Date: 06/19/2023
Certification Date: 03/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44 MCNEILL PLZ
WHITEVILLE NC
28472-8602
US

IV. Provider business mailing address

44 MCNEILL PLZ
WHITEVILLE NC
28472-8602
US

V. Phone/Fax

Practice location:
  • Phone: 910-642-0224
  • Fax:
Mailing address:
  • Phone: 910-642-0224
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MR. JOE CALCUTT
Title or Position: CFO
Credential:
Phone: 910-815-3122