Provider Demographics
NPI:1124722301
Name:FREEDOM CHOICE TRANSPORTATION
Entity type:Organization
Organization Name:FREEDOM CHOICE TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VILMA
Authorized Official - Middle Name:
Authorized Official - Last Name:AGRESOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:442-800-3945
Mailing Address - Street 1:PO BOX 2821
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92263-2821
Mailing Address - Country:US
Mailing Address - Phone:442-800-3945
Mailing Address - Fax:
Practice Address - Street 1:4425 E CAMINO PAROCELA
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92264-1451
Practice Address - Country:US
Practice Address - Phone:442-800-3945
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-30
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)