Organization
LIBERTY HEALTHCARE GROUP, LLC
Active
Other names
Liberty Home Care and Hospice
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
1220 21ST AVE N, MYRTLE BEACH, SC 29577-7401
(843) 839-2273
(843) 839-2277
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
HPC093
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007A
BLUE CROSS BLUE SHIELD
NC
05
—
HSP072
—
SC
Enumeration date
08/03/2006
Last updated
04/17/2008
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