Liberty Care, LLC

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

License

201016110114 Issued in CA

Legal business name

LIBERTY CARE, LLC

Practice address

6245 Mulan St
Corona, CA 92880-0793

Phone

(951) 280-3001

Fax

(951) 280-3002

NPI assigned

Jan 22, 2011

Organization subpart

No

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

Authorized official

Name

Mr. Robert McCollum Jr.

Title

Owner

Phone

(951) 280-3001

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1295654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295654400000",
    "number": "1629373634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3045 S ARCHIBALD AVE STE H",
            "address_2": "SUITE 299",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917619001",
            "telephone_number": "951-280-3001",
            "fax_number": "951-280-3002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6245 MULAN ST",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928800793",
            "telephone_number": "951-280-3001",
            "fax_number": "951-280-3002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-22",
        "last_updated": "2011-01-22",
        "status": "A",
        "authorized_official_last_name": "MCCOLLUM",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "951-280-3001",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "CA",
            "license": "201016110114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Non-emergency Medical Transport (VAN) in Corona, CA
• Providers in Corona, CA by specialty
• Non-emergency Medical Transport (VAN) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2011; 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.