Provider Demographics
NPI:1134683949
Name:LIBERTY MEDICAL SERVICES
Entity Type:Organization
Organization Name:LIBERTY MEDICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BRENNAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WORKINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-843-4937
Mailing Address - Street 1:4701 N FEDERAL HWY STE 405
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33064-6589
Mailing Address - Country:US
Mailing Address - Phone:561-843-4937
Mailing Address - Fax:
Practice Address - Street 1:4701 N FEDERAL HWY STE 405
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33064-6589
Practice Address - Country:US
Practice Address - Phone:561-843-4937
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-25
Last Update Date:2019-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies