Provider Demographics
NPI:1306241740
Name:FREEDOM MEDICAL SUPPLY INC.
Entity type:Organization
Organization Name:FREEDOM MEDICAL SUPPLY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:EIBLING
Authorized Official - Suffix:
Authorized Official - Credentials:LPT
Authorized Official - Phone:419-764-0256
Mailing Address - Street 1:100 S SANDUSKY AVE
Mailing Address - Street 2:
Mailing Address - City:UPPER SANDUSKY
Mailing Address - State:OH
Mailing Address - Zip Code:43351-1424
Mailing Address - Country:US
Mailing Address - Phone:877-721-8022
Mailing Address - Fax:
Practice Address - Street 1:100 S SANDUSKY AVE
Practice Address - Street 2:
Practice Address - City:UPPER SANDUSKY
Practice Address - State:OH
Practice Address - Zip Code:43351-1424
Practice Address - Country:US
Practice Address - Phone:877-721-8022
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-28
Last Update Date:2014-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies