Organization
LIBERTY HOME MEDICAL SUPPLY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN MICHAEL HAYES RN (DIRECTOR)
(248) 844-9669
Entity
Organization
Contact information
Practice address
1904 STAR BATT DR, ROCHESTER HILLS, MI 48309-3711
(248) 844-9669
(248) 844-9651
Mailing address
20509 NORTHVILLE PARK PL, #2006, NORTHVILLE, MI 48167-2939
(248) 844-9669
(248) 844-9651
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
54OH228090
BLUE CROSS BLUE SHIELD
MI
Enumeration date
10/25/2006
Last updated
08/22/2020
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