Organization
LIBERTY HEALTHCARE GROUP, LLC
Active
Other names
Liberty Home Care, 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
405 E MAIN ST, BENNETTSVILLE, SC 29512-3111
(843) 479-8711
(843) 454-0993
Mailing address
2334 S 41ST ST, WILMINGTON, NC 28403-5502
(910) 815-3122
(910) 815-3111
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
HHA159
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007A
BLUE CROSS BLUE SHIELD
SC
05
—
HHA159
—
SC
Enumeration date
05/25/2006
Last updated
10/04/2010
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