LIBERTY MEDICAL SUPPLY INC (NPI# 1245291798) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245291798 |
| Entity Type | Organization |
| Organization Name | LIBERTY MEDICAL SUPPLY INC |
| Practice Address |
10400 S Us Highway 1 Suite 500 Port St Lucie FL 34952-5600 |
| Mailing Address |
Po Box 403970 Atlanta GA 30384-3970 |
| Practice Telephone | 8668369936 |
| Practice Fax Number | 8886402184 |
| Mailing Telephone | 7723985800 |
| Mailing Fax Number | 7723982192 |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2011-10-13 |
| Authorized Official Name | JOAN KENNEDY (PRESIDENT) |
| Authorized Official Telephone | 7723985800 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 291U00000X | Clinical Medical Laboratory | 800017356 | FL | Laboratories |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MEDICARE PART B - FIRST COAST SERVICE OPTIONS | E9098 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396974416 | Liberty Medical Supply Inc | Durable Medical Equipment & Medical Supplies | 2313 Mermaid Ave, Brooklyn, NY 11224-2589 | 2009-07-10 |
| 1033426234 | Liberty Medical Supply Inc | Pharmacy | 10400 S Us Highway 1, Suite 200, Port St Lucie, FL 34952-5600 | 2010-09-09 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| North Carolina Corporations | Liberty Medical Supply Inc. | 160 Mine Lake Ct Ste 200, Raleigh, NC 27615 |
| Street Address |
10400 S US HIGHWAY 1 SUITE 500 |
| City | PORT ST LUCIE |
| State | FL |
| Zip Code | 34952-5600 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629342126 | Mariam A Zakhary | Pharmacist | 10400 S Us Highway 1, Suite 200, Port St Lucie, FL 34952-5600 | 2012-03-01 |
| 1871879221 | Medco Research Institute, L.L.C. | Clinical Medical Laboratory | 10400 S Us Highway 1, Suite # 500, Port St Lucie, FL 34952-5600 | 2011-10-31 |
| 1033426234 | Liberty Medical Supply Inc | Pharmacy | 10400 S Us Highway 1, Suite 200, Port St Lucie, FL 34952-5600 | 2010-09-09 |
| 1376850503 | Kenneth John Zielinski | Pharmacist | 10400 S Us Highway 1, Port St Lucie, FL 34952-5600 | 2010-09-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215587068 | Carehere LLC | Family Medicine | Carehere Clinic- St. Lucie Psl, 1680 Se Lyngate Drive, Port St Lucie, FL 34952 | 2019-09-13 |
| 1255998274 | Morningside Alf | Assisted Living Facility | 2233 Se Mroningside Alf, Port Saint Lucie, FL 34952 | 2019-05-24 |
| 1336611870 | Med Braces and Supplies, LLC | Durable Medical Equipment & Medical Supplies | 1484 Se Village Green Dr, Port St Lucie, FL 34952 | 2018-12-21 |
| 1689143794 | The Gift of Recovery, LLC | Counselor | 1801 Sw Hillmoor Drive, Suite C-101, Port St. Lucie, FL 34952 | 2018-11-19 |
| 1457830853 | Cathy L Sonier | Counselor | 357 Brazilian Circle, Port St Lucie, FL 34952 | 2018-08-07 |
| 1548756661 | Blo 7 Diabetes Institute Inc | Nutritionist | 1700 Sw Hillmoor Dr., Suite 305, Port St. Lucie, FL 34952 | 2018-07-02 |
| 1780194464 | Doctor's Choice Medical Center | Clinic/Center | 9164 S Us Highway 1, Port St Lucie, FL 34952 | 2017-10-06 |
| 1801305644 | Thandiwe Daley | Behavior Technician | 1935 Se Hillmoor Drive, Apt#159, Port St Lucie, FL 34952 | 2017-09-25 |
| 1700309408 | Lagrand Evan Andrews | Assistant Behavior Analyst | 265 Se Lenard Rd. Apartment 307, Port St. Lucie, FL 34952 | 2017-07-25 |
| 1578085148 | Lavetta S Ivey | Behavior Technician | 7190 Us Federal Hwy 1, Port Saint Lucie, FL 34952 | 2017-07-14 |
| Find all providers in zip 34952 | ||||
| Taxonomy Code | 291U00000X |
| Grouping | Laboratories |
| Classification | Clinical Medical Laboratory |
| (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. |
| Notes: Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881153393 | Mgm Labs LLC | Clinical Medical Laboratory | 11350 Sw Village Pkwy Ste 314, Port St Lucie, FL 34987-2352 | 2019-03-14 |
| 1083181622 | First Fisher Laboratories, LLC | Clinical Medical Laboratory | 11350 Sw Village Pkwy Ste 310, Port St Lucie, FL 34987-2352 | 2018-11-01 |
| 1689161051 | Lab Stop Usa, Inc | Clinical Medical Laboratory | 466 Sw Port St Lucie Blvd Ste 103, Port St Lucie, FL 34953-2090 | 2018-04-20 |
| 1326549734 | Bex Lab, LLC | Clinical Medical Laboratory | 7410 S Us Highway 1 Ste 402, Port St Lucie, FL 34952-1449 | 2018-02-22 |
| 1154859825 | True Path Diagnostics, LLC | Clinical Medical Laboratory | 11350 Sw Village Pkwy Ste 309, Port St Lucie, FL 34987 | 2017-05-25 |
| 1912371089 | Florida Lab Source | Clinical Medical Laboratory | 11350 Sw Village Pkwy, Port St Lucie, FL 34987-2352 | 2015-11-30 |
| 1174997902 | Oracle Reference Labs LLC | Clinical Medical Laboratory | 11350 Sw Village Pkwy Ste 326, Port St Lucie, FL 34987-2352 | 2015-11-17 |
| 1679873236 | Peacock Medical LLC | Clinical Medical Laboratory | 1091 Sw Bayshore Blvd, Port St Lucie, FL 34983-2463 | 2010-10-29 |
| 1477513323 | Indian River Pathology LLC | Clinical Medical Laboratory | 6696 S Us Highway 1, Port St Lucie, FL 34952-1423 | 2006-03-24 |
| 1134652514 | Tsa Labs LLC | Clinical Medical Laboratory | 11350 Sw Village Pkwy, Suite 311, Port St Lucie, FL 34987-2352 | 2017-04-04 |
| Find all providers in PORT ST LUCIE | ||||
| City | PORT ST LUCIE |
| Zip Code | 34952 |
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| 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.