Provider Demographics
NPI:1720849565
Name:LIBERTY MANAGEMENT
Entity Type:Organization
Organization Name:LIBERTY MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHARABI
Authorized Official - Middle Name:
Authorized Official - Last Name:FAARUWQ
Authorized Official - Suffix:
Authorized Official - Credentials:CNA
Authorized Official - Phone:336-232-8469
Mailing Address - Street 1:1088 EDENWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-5308
Mailing Address - Country:US
Mailing Address - Phone:336-232-8469
Mailing Address - Fax:
Practice Address - Street 1:500 W 5TH ST STE 800
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27101-3131
Practice Address - Country:US
Practice Address - Phone:980-666-8544
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-18
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251J00000XAgenciesNursing Care
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No164X00000XNursing Service ProvidersLicensed Vocational NurseGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No251B00000XAgenciesCase Management
No251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & SuppliesGroup - Multi-Specialty
No343800000XTransportation ServicesSecured Medical Transport (VAN)