LIBERTY HEALTHCARE GROUP LLC (NPI# 1104995745) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104995745 |
| Entity Type | Organization |
| Organization Name | LIBERTY HEALTHCARE GROUP LLC |
| Other Organization Name | LIBERTY HOME CARE, LLC |
| Practice Address |
1700 Country Club Rd Jacksonville NC 28546-6004 |
| Mailing Address |
2334 S 41st St Wilmington NC 28403-5502 |
| Practice Telephone | 9103464800 |
| Practice Fax Number | 9103465870 |
| Mailing Telephone | 9108153122 |
| Mailing Fax Number | 9108153111 |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2010-05-05 |
| Authorized Official Name | MR. ANTHONY J. ZIZZAMIA JR. (PRESIDENT/EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 9108153122 |
| Authorized Official Credential | RN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251G00000X | Hospice Care, Community Based | HOS2005 | NC | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | BLUE CROSS BLUE SHIELD | 007A | 01 |
| NC | 3411569 | 05 |
| Other Name | Type Code |
|---|---|
| Liberty Home Care, LLC | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376039446 | Liberty Healthcare Group LLC | Home Health | 216 Church Street, W, Ahoskie, NC 27910 | 2018-07-02 |
| 1346403151 | Liberty Healthcare Group LLC | Assisted Living Facility | 2315 Hwy 242 N, Benson, NC 27504 | 2008-07-02 |
| 1710021779 | Liberty Healthcare Group LLC | Skilled Nursing Facility | 4412 S Main St, Salisbury, NC 28147-9383 | 2007-02-16 |
| 1205979580 | Liberty Healthcare Group LLC | Skilled Nursing Facility | 1403 Conner Dr, Windsor, NC 27983-8514 | 2007-02-15 |
| 1912040379 | Liberty Healthcare Group LLC | Skilled Nursing Facility | 7348 N West St, Falcon, NC 28342-0040 | 2007-02-15 |
| 1194868679 | Liberty Healthcare Group LLC | Skilled Nursing Facility | 3000 Holston Ln, Raleigh, NC 27610-2002 | 2007-02-15 |
| 1225171762 | Liberty Healthcare Group LLC | Skilled Nursing Facility | 310 Commerce Dr, Sanford, NC 27332-5400 | 2007-02-15 |
| 1598808065 | Liberty Healthcare Group LLC | Skilled Nursing Facility | 714 Westover Dr, Sanford, NC 27330-8951 | 2007-02-15 |
| 1265575641 | Liberty Healthcare Group LLC | Skilled Nursing Facility | 120 Southwood Dr, Clinton, NC 28328-5002 | 2007-02-15 |
| 1073656716 | Liberty Healthcare Group LLC | Skilled Nursing Facility | 1402 Pinckney St, Whiteville, NC 28472-2221 | 2007-02-14 |
| Street Address |
1700 COUNTRY CLUB RD |
| City | JACKSONVILLE |
| State | NC |
| Zip Code | 28546-6004 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669427951 | Liberty Healthcare Group, LLC | Home Health | 1700 Country Club Rd, Jacksonville, NC 28546-6004 | 2006-05-24 |
| 1164557369 | Liberty Nursing Services, LLC | Nursing Care | 1700 Country Club Rd, Jacksonville, NC 28546-6004 | 2007-02-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316578388 | Judylyn Hobson | Registered Nurse | Pride In North Carolina, LLC, 3886 Henderson Dr, Jacksonville, NC 28546 | 2020-01-29 |
| 1427694637 | Aaron Patrick Bettcher | Military Health Care Provider | 3rd Mrb Loop Rd, Camp Lejeune, NC 28546 | 2019-11-22 |
| 1962044289 | Levi Scott Marshall | Military Health Care Provider | Everett Creek Road, Building 612, Camp Lejeune, NC 28546 | 2019-10-09 |
| 1649826652 | Nicholas Otazo | Military Health Care Provider | 3rd Mrb 20073, Camp Lejeune, NC 28546 | 2019-08-15 |
| 1417519570 | Publix North Carolina, Lp | Durable Medical Equipment & Medical Supplies | 2001 Marlin Drive Unit 100, Jacksonville, NC 28546 | 2019-06-28 |
| 1023500212 | Josip Ninrodriguez | Military Health Care Provider | 3d Marine Raider Battaliom, Camp Lejeune, NC 28546 | 2018-06-04 |
| 1639661192 | Kenneth Lee Russell | Military Health Care Provider | 3d Marine Raider Battalion, Camp Lejeune, NC 28546 | 2018-05-31 |
| 1346730173 | Coastal Foot Center, LLC | Clinic/Center | 29 Office Park Dr Ste B, Jacksonville, NC 28546 | 2018-05-17 |
| 1578080271 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 380 Western Blvd, Jacksonville, NC 28546 | 2017-08-24 |
| 1144757493 | Darin Lee Peterson | Specialist/Technologist | G644 Camp Geiger, School of Infantry-east, Jacksonville, NC 28546 | 2017-05-17 |
| Find all providers in zip 28546 | ||||
| Taxonomy Code | 251G00000X |
| Grouping | Agencies |
| Classification | Hospice Care, Community Based |
| Definition to come... |
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| 1902181944 | Hospice of Massachusetts, LLC | Hospice Care, Community Based | 50 N Laura St, Suite 1800, Jacksonville, FL 32202-3664 | 2011-10-20 |
| 1144459421 | Anntoinette Campbell | Hospice Care, Community Based | 7555 Beach Blvd Ste 200, Jacksonville, FL 32216-3003 | 2009-07-08 |
| 1275666273 | Hcr Manor Care Services of Florida, LLC | Hospice Care, Community Based | 8130 Baymeadows Way W, Suite 201, Jacksonville, FL 32256-7451 | 2007-03-13 |
| 1790723211 | Countryside Hospice Care Inc | Hospice Care, Community Based | 320 Branscomb Dr Sw, Suite D, Jacksonville, AL 36265 | 2006-06-04 |
| 1295789568 | Continuum II Home Care & Hospice, Inc. | Hospice Care, Community Based | 3886 Henderson Dr, Jacksonville, NC 28546-5219 | 2006-05-20 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 28546 |
Please comment or provide details below to improve the information on LIBERTY HEALTHCARE GROUP LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.