Provider Demographics
NPI:1275534026
Name:FREEDOM MEDICAL SERVICES INC
Entity type:Organization
Organization Name:FREEDOM MEDICAL SERVICES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:T
Authorized Official - Last Name:THURMAN JR
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:561-338-4900
Mailing Address - Street 1:4901 NW 17TH WAY STE 501
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33309-3774
Mailing Address - Country:US
Mailing Address - Phone:561-338-4900
Mailing Address - Fax:561-886-2777
Practice Address - Street 1:4901 NW 17TH WAY STE 501
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309-3774
Practice Address - Country:US
Practice Address - Phone:561-338-4900
Practice Address - Fax:561-886-2777
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FREEDOM MEDICAL SERVICES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-08-02
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2003-04658332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1568864Medicaid
KS7586942201Medicaid
AR139358741Medicaid
MD459400200Medicaid
AL009936190Medicaid
FL101794100Medicaid
AR139358741Medicaid
LA1568864Medicaid