LIBERTY RC INC NPI 1699261321

NPI Information

NPI: 1699261321
Provider Name: LIBERTY RC INC
Classification: Clinic/Center - 261QE0700X
Specialization: End-Stage Renal Disease (ESRD) Treatment
Entity Type: Organization
:
CLIA Number: 33D2161816
Address: 475 S TRANSIT ST
STE 900
LOCKPORT, NY
ZIP 14094
Phone: (716) 439-0590

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NPI Details

LIBERTY RC INC is an end-stage renal disease (esrd) treatment clinic center in Lockport, NY. LIBERTY RC INC NPI is 1699261321. The provider is registered as an organization entity type.
The provider .

The provider's business location address is:

475 S TRANSIT ST
STE 900
LOCKPORT, NY
ZIP 14094-562
Phone: (716) 439-0590
Fax: (716) 439-0595

The provider's authorized official is Samuel Wey .
The authorized official title is Assistant Secretary and has the following contact phone number (615) 341-6641.

The CLIA number assigned to this NPI record is 33D2161816 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/5/2018 and was last updated on 10/17/2025.

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
1	261QE0700X	Clinic/Center	End-Stage Renal Disease (ESRD) Treatment			Yes

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
1	05713213	MEDICAID	NEW YORK

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: 11/21/2025

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