Organization
LIBERTY MEDICAL SPECIALTIES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TOM OWENS RPH (PHARMACY MANAGER)
(910) 642-3009
Entity
Organization
Contact information
Practice address
620 JEFFERSON ST, WHITEVILLE, NC 28472
(910) 642-3065
(910) 642-3765
Mailing address
PO BOX 339, WHITEVILLE, NC 28472-0339
(910) 642-3065
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
04935
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0245654
—
NC
01
—
2069875
PK
—
Enumeration date
09/21/2006
Last updated
06/06/2018
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