Organization
LIBERTY MEDICAL SPECIALTIES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TAMARA LYNN JONES (BILLING MANAGER)
(910) 642-2250
Entity
Organization
Contact information
Practice address
612-10 E JEFFERSON STREET, WHITEVILLE, NC 28472
(910) 642-2250
Mailing address
PO BOX 339, WHITEVILLE, NC 28472
(910) 642-2250
Taxonomy
Speciality
Code
Description
License number
State
3336H0001X
Home Infusion Therapy Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0245720
—
NC
01
—
0473G
BCBS
NC
01
—
3437426
NCPDP#
NC
05
—
6800282
—
NC
05
—
7N5573
—
SC
Enumeration date
05/09/2007
Last updated
06/28/2011
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