Provider Demographics
NPI:1528377058
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:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FRANCIS
Authorized Official - Middle Name:M
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:952-920-0480
Practice Address - Street 1:14001 GRAND AVE
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337-5701
Practice Address - Country:US
Practice Address - Phone:952-898-5008
Practice Address - Fax:952-898-5009
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LIBERTY OXYGEN AND HOME CARE, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-10-01
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
MN183427400Medicaid
MN1030361OtherPREFERRED ONE
MN170158OtherUCARE
MN83371OtherHEALTH PARTNERS
MN79B05LIOtherBLUE CROSS BLUE SHIELD