| Liberty Resources, Inc. | |
|
1045 James St Syracuse NY 13203-2730 | |
| (315) 425-1004 | |
| Not Available |
| Full Name | Liberty Resources, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 1045 James St, Syracuse, New York |
| Authorized Official Name and Position | Kelli Harris (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 3154251004 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Liberty Resources, Inc. 1045 James St Syracuse NY 13203-2730 Ph: (315) 425-1004 | Liberty Resources, Inc. 1045 James St Syracuse NY 13203-2730 Ph: (315) 425-1004 |
| NPI Number | 1922789163 |
|---|---|
| Provider Enumeration Date | 07/31/2023 |
| Last Update Date | 07/31/2023 |
| Medicare PECOS PAC ID | 4486703352 |
|---|---|
| Medicare Enrollment ID | O20231221002838 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922789163 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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