Organization
LIBERTY MEDICAL SUPPLY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FRANK A HARVEY (PRESIDENT/DIRECTOR)
(772) 398-5860
Entity
Organization
Contact information
Practice address
10400 S US HIGHWAY 1, SUITE 200, PORT ST LUCIE, FL 34952-5600
(866) 907-0835
(877) 592-8466
Mailing address
8881 LIBERTY LN, ATTN:COMPLIANCE, PORT ST LUCIE, FL 34952-3477
(772) 398-5800
(772) 398-2192
Taxonomy
Speciality
Code
Description
License number
State
3336M0002X
Mail Order Pharmacy
Primary
PH16634
FL
Other
Enumeration date
09/09/2010
Last updated
11/30/2012
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