Provider Demographics
NPI:1578258703
Name:LIVEFREE MEDICAL LLC
Entity Type:Organization
Organization Name:LIVEFREE MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:VALBONA
Authorized Official - Middle Name:KALLARI
Authorized Official - Last Name:WESTDYK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-783-0605
Mailing Address - Street 1:6818 SEEWEE RD
Mailing Address - Street 2:
Mailing Address - City:AWENDAW
Mailing Address - State:SC
Mailing Address - Zip Code:29429-6081
Mailing Address - Country:US
Mailing Address - Phone:888-783-0605
Mailing Address - Fax:888-783-0606
Practice Address - Street 1:6818 SEEWEE RD
Practice Address - Street 2:
Practice Address - City:AWENDAW
Practice Address - State:SC
Practice Address - Zip Code:29429-6081
Practice Address - Country:US
Practice Address - Phone:888-783-0605
Practice Address - Fax:888-783-0605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-05
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies