Provider Demographics
NPI:1679714182
Name:LIBERTY AMBULANCE SERVICES, INC
Entity type:Organization
Organization Name:LIBERTY AMBULANCE SERVICES, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MOHAMMED
Authorized Official - Middle Name:
Authorized Official - Last Name:USMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-224-4924
Mailing Address - Street 1:1516 OSPREY DR
Mailing Address - Street 2:STE 204
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-2429
Mailing Address - Country:US
Mailing Address - Phone:972-224-4924
Mailing Address - Fax:972-224-4950
Practice Address - Street 1:1516 OSPREY DR
Practice Address - Street 2:STE 204
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-2429
Practice Address - Country:US
Practice Address - Phone:972-224-4924
Practice Address - Fax:972-224-4950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-12
Last Update Date:2009-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance