Provider Demographics
NPI:1164854592
Name:LIBERTY OXYGEN AND HOME CARE, INC
Entity Type:Organization
Organization Name:LIBERTY OXYGEN AND HOME CARE, INC
Other - Org Name:LIBERTY OXYGEN AND MEDICAL EQUIPMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FRANCIS
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEEHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-920-0460
Mailing Address - Street 1:4820 PARK GLEN RD
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55416-5702
Mailing Address - Country:US
Mailing Address - Phone:952-920-0460
Mailing Address - Fax:
Practice Address - Street 1:11650 ROUND LAKE BLVD NW
Practice Address - Street 2:107
Practice Address - City:COON RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:55433-2700
Practice Address - Country:US
Practice Address - Phone:763-231-2077
Practice Address - Fax:763-231-2177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-08
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5677949332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN79B05LIOtherBLUE CROSS BLUE SHIELD
MN1030361OtherPREFERRED ONE
MN170158OtherUCARE
MN183427400Medicaid
MN83371OtherHEALTH PARTNERS