Organization
LIBERTY LAKE MEDICAL SUPPLY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTY LYNN CHAMBERLAIN (PRESIDENT)
(509) 891-2856
Entity
Organization
Contact information
Practice address
22910 E APPLEWAY AVE STE 3, LIBERTY LAKE, WA 99019-8606
(509) 891-2856
(509) 891-0125
Mailing address
22910 E APPLEWAY AVE STE 3, LIBERTY LAKE, WA 99019-8606
(509) 891-2856
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
602016543
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1952522823
—
WA
Enumeration date
03/12/2013
Last updated
03/12/2013
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