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LIBERTY III MANAGEMENT TR NPI 1932257375


NPI Information

NPI: 1932257375
Provider Name: LIBERTY III MANAGEMENT TR

Doing Business As: PROFESSIONAL MEDICAL OXYGEN

Classification: Durable Medical Equipment & Medical Supplies - 332B00000X
Entity Type: Organization
Address:
21620 N 19TH AVE
A102
PHOENIX, AZ
ZIP 85027
Phone: (623) 587-0012
Get Directions

LIBERTY III MANAGEMENT TR is a durable medical equipment medical supplies in Phoenix, AZ. The provider is a supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time. LIBERTY III MANAGEMENT TR NPI is 1932257375. The provider is registered as an organization entity type.
The provider Is Doing Business As Professional Medical Oxygen.

The provider's business location address is:

21620 N 19TH AVE
A102
PHOENIX, AZ
ZIP 85027-716
Phone: (623) 587-0012
Fax: (623) 587-7533

The provider's authorized official is David Cornejo .
The authorized official title is General Manager and has the following contact phone number (623) 587-0012.

The enumeration date for this NPI number is 1/8/2007 and was last updated on 11/2/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1332B00000XDurable Medical Equipment & Medical Supplies07498747MARIZONAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
10994420001MEDICARE ID-TYPE UNSPECIFIEDARIZONAMEDICARE ID#

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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