Liberty Pharmacy Inc

LBN: Liberty Pharmacy Inc
Liberty Pharmacy Inc is an health care organization with primary practice located at 4802 W Vernor Hwy , Detroit MI 48209-2122. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Long Term Care Pharmacy. Suppliers / Long Term Care Pharmacy is the primary health care specialty. Liberty Pharmacy Inc can be contacted via phone (313) 841-1990, or through Esho, Goerge via phone (313) 841-1990.

Contact Information

Primary practice address
4802 W Vernor Hwy Detroit MI 48209-2122
Phone: (313) 841-1990
Fax: (313) 841-6966
Website:
Map and Directions
Authorized official contact:
Name: Esho, Goerge
Phone: (313) 841-1990

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Long Term Care Pharmacy 3336L0003X 5301006438 Michigan

Profile Details

NPI number 1750873535
LBN Legal business name Liberty Pharmacy Inc
DBA Doing business as Liberty Pharmacy Inc
Authorized official Esho, Goerge
Entity Organization
Organization subpart 1 No
Enumeration date Jun 6th, 2018
Last updated Jun 6th, 2018 - about 7 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1750873535 NPPES
Michigan MEDICAID 1326143603
Michigan Other 2177576

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