| Liberty Community Health Care, Inc | |
|
17316 Ne State Road 65 Hosford FL 32334-2415 | |
| (850) 379-5800 | |
| (850) 379-5811 |
| Full Name | Liberty Community Health Care, Inc |
|---|---|
| Speciality | General Practice |
| Location | 17316 Ne State Road 65, Hosford, Florida |
| Authorized Official Name and Position | Peggy Deason Howland (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 8503795800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Liberty Community Health Care, Inc 17316 Ne State Road 65 Hosford FL 32334-2415 Ph: (850) 379-5800 | Liberty Community Health Care, Inc 17316 Ne State Road 65 Hosford FL 32334-2415 Ph: (850) 379-5800 |
| NPI Number | 1962875435 |
|---|---|
| Provider Enumeration Date | 11/05/2015 |
| Last Update Date | 01/04/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962875435 | NPI | - | NPPES |
| 016050000 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | OS7759 (Florida) | Primary |