Liberty Health Supplies, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

0285908-000 Issued in CT

Legal business name

LIBERTY HEALTH SUPPLIES, LLC

Doing business as

Liberty Rehab & Patient Aid Center

Practice address

1151 Stratford Ave
Stratford, CT 06615-6312

Phone

(203) 377-1144

Fax

(866) 381-6072

NPI assigned

Jul 4, 2006

Last updated

Jul 14, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. William Fletcher

Title

President

Phone

(203) 377-1144

Specialties & licenses 1

Addresses

Other identifiers 6

Other names 1

• Liberty Rehab & Patient Aid Center Doing business as

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468454400000",
    "number": "1427088343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1151 STRATFORD AVE",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066156312",
            "telephone_number": "203-377-1144",
            "fax_number": "866-381-6072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1151 STRATFORD AVE",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066156312",
            "telephone_number": "203-377-1144",
            "fax_number": "866-381-6072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY HEALTH SUPPLIES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-04",
        "last_updated": "2016-07-14",
        "status": "A",
        "authorized_official_last_name": "FLETCHER",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "203-377-1144",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CT",
            "license": "0285908-000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD HEALTH",
            "identifier": "A881654",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "2V6016",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004235728",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE OF CONN.",
            "identifier": "171441",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS & BLUE SHIELD",
            "identifier": "12DME0968CT01",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EVERCARE",
            "identifier": "82-02085",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Liberty Rehab & Patient Aid Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sally S. Lee, M.D.
• Rose Marie Leger, NP
• Corey Leite, APRN
• Jose Lezcano
• Ning Li, M.D.
• Liberty Health Supplies, LLC (Liberty Rehab & Patient Aid Center)
• Michael William Licamele, PHARM. D.
• Lighthouse Dental Care, LLC
• Andrew Lin
• Eric C Lin, PHARMD

• Durable Medical Equipment & Medical Supplies in Stratford, CT
• Providers in Stratford, CT by specialty
• Durable Medical Equipment & Medical Supplies in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2016; 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.