Provider Demographics
NPI:1407894827
Name:FREEDOM SUPPLIES INC
Entity type:Organization
Organization Name:FREEDOM SUPPLIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GRETCHEN
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:RAKOWICZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-656-8900
Mailing Address - Street 1:20853 FARMINGTON RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48336
Mailing Address - Country:US
Mailing Address - Phone:877-246-8672
Mailing Address - Fax:877-569-2727
Practice Address - Street 1:20853 FARMINGTON RD
Practice Address - Street 2:SUITE 102
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48336
Practice Address - Country:US
Practice Address - Phone:877-246-8672
Practice Address - Fax:877-569-2727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-04
Last Update Date:2012-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI540F302370OtherMI BCBS PROVIDER NUMBER
MI5205920001Medicare NSC