Organization
LIBERTY HEALTH SUPPLIES LLC
Active
Other names
Liberty Rehab & Patient Aid Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM FLETCHER (PRESIDENT)
(203) 732-4269
Entity
Organization
Contact information
Practice address
49 PERSHING DR, DERBY, CT 06418-1437
(203) 732-4269
(203) 732-4062
Mailing address
49 PERSHING DR, DERBY, CT 06418-1437
(203) 732-4269
(203) 732-4062
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
0285908
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12DME0968CT01
ANTHEM BLUE CROSS & BLUE SHIELD
CT
01
—
171441
WELLCARE OF CONNECTICUT
CT
01
—
2V6016
HEALTHNET
CT
01
—
772608
CONNECTICARE
CT
01
—
8202085
EVERCARE
CT
Enumeration date
02/16/2010
Last updated
02/16/2010
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