# LIBERTY MEDICAL,SUPPLY CO

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003937905
- **Authorized official:** OLABISI ADEBOWALE (DIRECTOR)
- **Authorized official phone:** (951) 924-8500

## Contact information

- **Practice address:** 24877 SUNNYMEAD BLVD, MORENO VALLEY, CA 92553-3702
- **Practice address phone:** (951) 924-8500
- **Practice address fax:** (951) 924-0151
- **Mailing address:** 24877 SUNNYMEAD BLVD, MORENO VALLEY, CA 92553-3702
- **Mailing address phone:** (951) 924-8500
- **Mailing address fax:** (951) 924-0151

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 46993 | CA | Yes |

## Other

- **Enumeration date:** 04/02/2007
- **Last updated:** 12/14/2007