Provider Demographics
NPI:1497069538
Name:LIBIR, LLC
Entity Type:Organization
Organization Name:LIBIR, LLC
Other - Org Name:LIBERTY DIALYSIS - IRVING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:L
Authorized Official - Last Name:BLANTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-699-9000
Mailing Address - Street 1:1111 W AIRPORT FWY STE 101
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75062-6204
Mailing Address - Country:US
Mailing Address - Phone:972-746-4747
Mailing Address - Fax:972-746-4746
Practice Address - Street 1:1111 W AIRPORT FWY STE 101
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75062-6204
Practice Address - Country:US
Practice Address - Phone:972-746-4747
Practice Address - Fax:972-746-4746
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRESENIUS MEDICAL CARE HOLDINGS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-07-30
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment