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NPI Code Detail

MEDICARE: LIBERTY CARE MEDICAL LLC

MEDICARE: LIBERTY CARE MEDICAL LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332BD1200XDialysis Equipment & Supplies (DME)

General Provider Information

NPI Number : 1528916350
Entity Type Code : Organization
Provider Name (Legal Business Name) : LIBERTY CARE MEDICAL LLC
Provider Business Mailing Address
First Line : 1021 E LINCOLNWAY STE 9992
Second Line :
City : CHEYENNE
State : WY
Zip : 82001-4851
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1021 E LINCOLNWAY STE 9992
Second Line :
City : CHEYENNE
State : WY
Zip : 82001-4851
Country : US
Telephone Number : 469-915-5044
Fax Number :
Authorized Official
Title or Position : AUTHORIZED OFFICIAL
Name : WESLEY MEDEIROS DA SILVA
Credential :
Telephone Number : 469-915-5044
Provider Enumeration Date : 03/18/2026
Last Update Date : 03/18/2026

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Directions to “LIBERTY CARE MEDICAL LLC ” Practice Location

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