Provider Demographics
NPI:1972514693
Name:FREEDOM ACQUISITION COMPANY
Entity type:Organization
Organization Name:FREEDOM ACQUISITION COMPANY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:WEBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-929-3456
Mailing Address - Street 1:5100 EDEN AVENUE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55436
Mailing Address - Country:US
Mailing Address - Phone:929-929-3456
Mailing Address - Fax:952-929-3466
Practice Address - Street 1:5100 EDEN AVENUE
Practice Address - Street 2:SUITE 204
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55436
Practice Address - Country:US
Practice Address - Phone:929-929-3456
Practice Address - Fax:952-929-3466
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41757500Medicare ID - Type UnspecifiedWI MEDICAID
4633400001Medicare ID - Type Unspecified