Liberty Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

P07520 Issued in MD

Legal business name

LIBERTY PHARMACY LLC

Doing business as

Liberty Pharmacy LLC

Practice address

108 N Eutaw St
Baltimore, MD 21201-2154

Phone

(443) 948-5400

Fax

(443) 948-5408

NPI assigned

Apr 11, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kingsley Neboh

Title

Owner/Pharmacist

Phone

(240) 547-8698

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• LIBERTY PHARMACY LLC Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1491868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491868800000",
    "number": "1356874820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 N EUTAW ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212012154",
            "telephone_number": "443-948-5400",
            "fax_number": "443-948-5408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 N EUTAW ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212012154",
            "telephone_number": "443-948-5400",
            "fax_number": "443-948-5408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-11",
        "last_updated": "2017-04-11",
        "status": "A",
        "authorized_official_last_name": "NEBOH",
        "authorized_official_first_name": "KINGSLEY",
        "authorized_official_title_or_position": "OWNER/PHARMACIST",
        "authorized_official_telephone_number": "240-547-8698"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MD",
            "license": "P07520",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2168825",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LIBERTY PHARMACY LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Liberty Leasing Co., LLC (BridgePark Healthcare Center)
• Liberty Medical & Injury Center
• Liberty Medical &Injury Center
• Liberty Medical Services, LLC
• Liberty Nursing Referral Service
• Carol Ann Libonati, APRN
• Isabel Licata
• Carmen Susanne Licavoli, MSN, APRN-BC
• Denise Lichaa, R.D., L.D.N.
• Richard Lichenstein, M.D.

• Community/Retail Pharmacy in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Community/Retail Pharmacy in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.