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Organization
ERAJ HOLDINGS, LLC
Active
Organization
ERAJ HOLDINGS, LLC
Active
Other names
Liberty Home Care, Liberty Home Care V, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD BENJAMIN MCNEILL (MANAGER)
(910) 815-3122
Entity
Organization
Contact information
Practice address
797 WOODLAND DR STE 103, STUART, VA 24171-5132
(276) 755-4766
(276) 755-4225
Mailing address
2334 S 41ST ST, WILMINGTON, NC 28403-5502
(910) 815-3122
(991) 081-5311
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007CH
BLUE CROSS BLUE SHIELD
VA
05
—
4907475
—
VA
01
—
497475
MEDICARE
VA
Enumeration date
05/06/2009
Last updated
06/16/2018
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