Organization
LIBERTY HEALTHCARE GROUP LLC
Active
Other names
Liberty Home Care II, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANTHONY J. ZIZZAMIA JR. RN (PRESIDENT/EXECUTIVE DIRECTOR)
(910) 815-3122
Entity
Organization
Contact information
Practice address
1317 N BRIGHTLEAF BLVD STE C, SMITHFIELD, NC 27577-7267
(919) 989-6792
(919) 989-8519
Mailing address
2334 S 41ST ST, WILMINGTON, NC 28403-5502
(910) 815-3122
(910) 815-3111
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
HOS3069
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007CH
BLUE CROSS BLUE SHIELD
NC
05
—
3421537
—
NC
Enumeration date
10/27/2006
Last updated
05/05/2010
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