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General NPI Number Information
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NPI Number | 1750450730
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Entity Type | Organization
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Legal Business Name | LIBERTY HOME CARE, LLC
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Dates
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Enumeration Date | 11/06/2006
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Last Update Date | 02/04/2008
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Provider Practice Location Address
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Address Line | 2309 W CONE BLVD STE 110
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City | GREENSBORO
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State | NC
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Zip | 27408-4045
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Country | US
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Telephone | 336-545-9609
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Fax | 336-545-9701
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Provider Business Mailing Address
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Address Line | 2334 S 41ST ST
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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 | PRESIDENT/EXECUTIVE DIRECTOR
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Name | MR. ANTHONY J. ZIZZAMIA JR.
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Credential | RN
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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 | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | HOS3110
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License Number State | NC
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