Provider Demographics
NPI:1740696988
Name:LIBERTY EMS SERVICES LLC
Entity type:Organization
Organization Name:LIBERTY EMS SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PARTNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:DORIS
Authorized Official - Last Name:RUSHWORTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-227-1768
Mailing Address - Street 1:28500 GILCHRIST DR
Mailing Address - Street 2:
Mailing Address - City:WILLOWICK
Mailing Address - State:OH
Mailing Address - Zip Code:44095-4566
Mailing Address - Country:US
Mailing Address - Phone:440-227-1768
Mailing Address - Fax:
Practice Address - Street 1:1294 W 70TH ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44102-2018
Practice Address - Country:US
Practice Address - Phone:216-630-6626
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-09
Last Update Date:2014-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)