Healthcare Provider Details

I. General information

NPI: 1811891369
Provider Name (Legal Business Name): LIBERTY MEDICAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39 MANOR HOUSE DR
CHERRY HILL NJ
08003-5134
US

IV. Provider business mailing address

PO BOX 1732
BRIDGETON NJ
08302-0471
US

V. Phone/Fax

Practice location:
  • Phone: 856-455-5140
  • Fax: 800-963-7620
Mailing address:
  • Phone: 856-455-5140
  • Fax: 800-963-7620

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: KELLI WILLIAMS
Title or Position: OFFICE MANAGER
Credential:
Phone: 856-455-5140