Liberty Drug – Long Term Care Pharmacy, NPI 1093346546
Long Term Care Pharmacy
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Liberty Drug
497 W 4800 S STE 100
MURRAY, UT 841234663
Phone: (801) 810-0337
Fax: (877) 540-2727
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2020-12-29
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Revalidation scheduled
Earliest CMS due date is 2026-09-30 (113 days away).
Enrollment records
2
Earliest due date
2026-09-30
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20201211002797 | O | Mass Immunization (Roster Biller Only) | UT | 2026-09-30 |
| O20201229001646 | O | Pharmacy | UT | 2026-10-31 |
What to do next
- Monitor the published due date as it approaches.
- Plan to revalidate in PECOS within the window CMS allows before the due date.
- Verify the date on the CMS Revalidation Lookup Tool before submitting.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 91320 | Sarscv2 vac 30mcg trs-suc im | 185 | 184 | $0 |
| 90480 | Admn sarscov2 vacc 1 dose | 185 | 184 | $0 |
| G0009 | Administration of pneumococcal vaccine | 43 | 42 | $0 |
| 90677 | Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use | 42 | 41 | $0 |
| 90686 | Influenza vaccine, quadrivalent, preservative free, 0.5 ml dosage | 41 | 41 | $0 |
Insurance plans in this area (ZIP 84123)
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