Liberty Home Pharmacy Corporation

Primary specialty

PharmacyTaxonomy code 333600000X

Legal business name

LIBERTY HOME PHARMACY CORPORATION

Practice address

8881 Liberty LN
Port St Lucie, FL 34952-3477

Phone

(877) 891-2545

Fax

(877) 891-2546

NPI assigned

Oct 31, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Robert N Mark

Title

President

Phone

(772) 398-5800

Specialties & licenses 1

Addresses

Other identifiers 9

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1730170663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20003",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349790003",
            "telephone_number": "877-891-2545",
            "fax_number": "877-891-2546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8881 LIBERTY LN",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349523477",
            "telephone_number": "877-891-2545",
            "fax_number": "877-891-2546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY HOME PHARMACY CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MARK",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "772-398-5800",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "73850080",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0001035416",
            "state": "DE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "90002262",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "514902",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "51901902",
            "state": "HI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0548313",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1268330",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MS383FL",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00864432A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Megan Leigh Lewis
• Steven Patrick Lewis, MD
• Iker Leycegui-Gardoqui, MD
• Shawndre Marie Leydon, LMHC
• Gabrielle Lezeau
• Liberty Medical Response Inc
• Liberty Medical Supply Inc
• Liberty Medical Supply Inc
• Life Care Centers of America, Inc.
• Life Chiropractic Center PA

• Pharmacy in Port St Lucie, FL
• Providers in Port St Lucie, FL by specialty
• Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.