LIBERTY RC INC (NPI# 1184930083) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184930083 |
| Entity Type | Organization |
| Organization Name | LIBERTY RC INC |
| Other Organization Name | SOUTHTOWNS DIALYSIS CENTER |
| Practice Address |
4910 Camp Rd Ste 100 Hamburg NY 14075-2617 |
| Mailing Address |
5200 Virginia Way L & C Dept Brentwood TN 37027-7569 |
| Practice Telephone | 7166494072 |
| Practice Fax Number | 7166491937 |
| Mailing Telephone | 6153416410 |
| Mailing Fax Number | 8886628259 |
| Enumeration Date | 2010-08-30 |
| Last Update Date | 2020-06-23 |
| Authorized Official Name | JOHN D WINSTEL (CHIEF ACCOUNTING OFFICER) |
| Authorized Official Telephone | 2537334501 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 03335568 | 05 |
| Other Name | Type Code |
|---|---|
| Southtowns Dialysis | Doing Business As Name - Organization |
| Southtowns Dialysis Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639727852 | Liberty Rc Inc | Clinic/Center | 2521 Walden Ave Ste 600, Cheektowaga, NY 14225-4737 | 2019-08-30 |
| 1699261321 | Liberty Rc Inc | Clinic/Center | 475 S Transit St Ste 900, Lockport, NY 14094-5562 | 2018-07-05 |
| 1205353513 | Liberty Rc Inc | Clinic/Center | 3958 Vineyard Dr, Dunkirk, NY 14048-3522 | 2017-08-28 |
| 1619377330 | Liberty Rc Inc | Clinic/Center | 2932 Military Rd, Niagara Falls, NY 14304-1252 | 2014-08-29 |
| 1154537132 | Liberty Rc Inc | Clinic/Center | 3117 Webster Ave, Fl 1, Bronx, NY 10467-4905 | 2007-05-15 |
| 1043377922 | Liberty Rc Inc | Clinic/Center | 1515 Jarrett Pl, Bronx, NY 10461-2606 | 2007-01-02 |
| 1265461487 | Liberty Rc Inc | Clinic/Center | 155 White Plains Rd, Tarrytown, NY 10591-5523 | 2006-07-01 |
| 1578591152 | Liberty Rc Inc | Clinic/Center | 611 W Hartsdale Ave Fl 1, White Plains, NY 10607-1811 | 2006-06-30 |
| 1245763804 | Liberty Rc Inc | Clinic/Center | 699 Hertel Ave, Ste 380, Buffalo, NY 14207-2355 | 2017-04-10 |
| 1326498205 | Liberty Rc Inc | Clinic/Center | 1940 Webster Ave, 2nd Floor, Bronx, NY 10457-4261 | 2016-06-21 |
| Street Address |
4910 CAMP RD STE 100 |
| City | HAMBURG |
| State | NY |
| Zip Code | 14075-2617 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538781281 | Devan Fischer | Student in an Organized Health Care Education/Training Program | 6490-17 Taylor Woods Road, Hamburg, NY 14075 | 2020-05-15 |
| 1417590746 | Jackson Mar | Counselor | 140 Pine St., Hamburg, NY 14075 | 2019-10-18 |
| 1831666122 | Andrea Lynn Baron | Physician Assistant | 5022 Morgan Parkway, Hamburg, NY 14075 | 2018-10-25 |
| 1164905584 | Michael Grundtisch | Physical Therapist | 5284 Briercliff Drive, Hamburg, NY 14075 | 2018-09-11 |
| 1629571187 | Dawn Rydzynski | Counselor | 140 Pin St, Hamburg, NY 14075 | 2018-03-12 |
| 1760990873 | Buffalo Orthopaedic Group, LLP | Orthopaedic Surgery | 4901 Camp Rd. Suite 100, Buffalo Orthopaedic Group, LLP, Hamburg, NY 14075 | 2018-01-11 |
| 1821500562 | Theresa M Tripi | Counselor | 140 Pin Street, Hamburg, NY 14075 | 2017-11-03 |
| 1831548841 | Mary Coble | Student in an Organized Health Care Education/Training Program | 6490-17 Taylor Road, Hamburg, NY 14075 | 2016-06-09 |
| 1700287737 | Jessica Schreiner | Occupational Therapist | 6490-17 Taylor Rd, Hamburg, NY 14075 | 2014-09-09 |
| 1235576976 | Christina Lowman | Dietitian, Registered | 4535 Southwestern Blvd Suite 804a, Southtowns Medical and Professional Park, Hamburg, NY 14075 | 2013-06-03 |
| Find all providers in zip 14075 | ||||
| Taxonomy Code | 261QE0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | End-Stage Renal Disease (ESRD) Treatment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194323071 | True North Dialysis Center LLC | Clinic/Center | 668 Middle Country Rd, Selden, NY 11784-2521 | 2020-10-13 |
| 1952908386 | Ulster Dialysis, LLC | Clinic/Center | 900 Miron Ln, Kingston, NY 12401-1567 | 2020-10-08 |
| 1376152868 | True North Dialysis Center LLC | Clinic/Center | 3005 Long Beach Rd, Oceanside, NY 11572 | 2020-07-30 |
| 1043839269 | Knickerbocker Dialysis Inc | Clinic/Center | 5518 Avenue N, Brooklyn, NY 11234-4006 | 2020-04-09 |
| 1942839378 | Knickerbocker Dialysis Inc | Clinic/Center | 479 E Main St, Patchogue, NY 11772-3147 | 2020-04-07 |
| 1225667819 | New York Dialysis Services, Inc | Clinic/Center | 1 East Jericho Turnpike, Mineola, NY 11501 | 2020-04-06 |
| 1205461639 | Knickerbocker Dialysis Inc | Clinic/Center | 1277 Middle Country Rd, Middle Island, NY 11953 | 2020-03-05 |
| 1326678111 | New York Dialysis Services, Inc | Clinic/Center | 794 St Anns Ave, Bronx, NY 10456 | 2020-01-21 |
| 1629617576 | Knickerbocker Dialysis Inc | Clinic/Center | 1633 Route 202 Ste 120, Pomona, NY 10970-2926 | 2019-12-24 |
| 1740824184 | Knickerbocker Dialysis Inc | Clinic/Center | 11 Romaine Ave, Yonkers, NY 10705 | 2019-10-29 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on LIBERTY RC INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.