# LIBERTY REGIONAL MEDICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Other names:** LIBERTY REGIONAL MEDICAL CENTER
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184641623
- **Authorized official:** DEREK ROZIER (CFO)
- **Authorized official phone:** (912) 369-9427

## Contact information

- **Practice address:** 462 E G MILES PKWY, HINESVILLE, GA 31313-4000
- **Practice address phone:** (912) 369-9478
- **Practice address fax:** (800) 611-2089
- **Mailing address:** 462 E G MILES PKWY, HINESVILLE, GA 31313-4000
- **Mailing address phone:** (912) 369-9478
- **Mailing address fax:** (800) 611-2089

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | — |
| 3336I0012X | Institutional Pharmacy | PHRE008347 | GA | — |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 07/17/2006
- **Last updated:** 11/21/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2013760 | PK | — |