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Liberty Medical Specialties fax number

(843) 448-8317

Breast Pumps

Used for: Breast pump order submission; physician order / CMN processing

Fax destination details

Department
Breast Pumps
Purpose
Breast pump order submission; physician order / CMN processing
Form
Breast Pump Physicians Order/ CMN — Breast Pump Physicians Order/ CMN
Address
1768 Highway 501, Myrtle Beach, SC 29577
Voice phone
1-843-448-8315

Before you send

  • Confirm that this exact department handles your document or request.
  • Check the organization website or call its main line for the current fax number.
  • Include a cover sheet and any case, member, claim, or form reference required.
  • Keep the delivery confirmation with your submission records.

Fax this form with a copy of the patient’s insurance and demographic information to 843-448-8317. Complete patient name, DOB, SSN, address, insurance details, policy number, physician signature, clinic name/address, and product codes for the breast pump order.

Review official form instructions

Sources and verification

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