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
2550 S 41ST ST, WILMINGTON, NC 28403-5519
(910) 251-8111
(910) 343-1218
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
HC0196
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007A
BLUE CROSS BLUE SHIELD
NC
05
—
3417001
—
NC
Enumeration date
05/24/2006
Last updated
02/04/2008
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