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General NPI Number Information
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NPI Number | 1861537037
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Entity Type | Organization
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Legal Business Name | LIBERTY NURSING SERVICES, LLC
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Dates
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Enumeration Date | 02/21/2007
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Last Update Date | 09/24/2007
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Provider Practice Location Address
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Address Line | 5017 MEMORY RD
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City | RALEIGH
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State | NC
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Zip | 27609-5589
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Country | US
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Telephone | 919-850-4303
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Fax | 919-850-4304
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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 | MANAGER
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Name | MR. RONALD B 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 | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | HC2315
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License Number State | NC
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