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General NPI Number Information
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NPI Number | 1376039446
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Entity Type | Organization
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Legal Business Name | LIBERTY HEALTHCARE GROUP LLC
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Dates
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Enumeration Date | 07/02/2018
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Last Update Date | 03/12/2024
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Provider Practice Location Address
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Address Line | 216 CHURCH ST E
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City | AHOSKIE
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State | NC
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Zip | 27910-3518
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Country | US
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Telephone | 252-926-3715
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Fax | 252-926-3702
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Provider Business Mailing Address
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Address Line | 2334 SOUTH 41ST. STREET
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City | WILMINGTON
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State | NC
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Zip | 28403-5502
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Country | US
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Telephone | 910-815-3122
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Fax | 910-815-3111
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Authorized Official
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Title or Position | MANAGER
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Name | RONALD BENJAMIN MCNEILL
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Credential |
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Telephone | 910-815-3122
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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