Provider Demographics
NPI:1972536076
Name:FREEDOM MEDICAL SUPLY, INC.
Entity type:Organization
Organization Name:FREEDOM MEDICAL SUPLY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMPLIANCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:HERSH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-396-9842
Mailing Address - Street 1:36 TERRY DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:TREVOSE
Mailing Address - State:PA
Mailing Address - Zip Code:19053-6518
Mailing Address - Country:US
Mailing Address - Phone:215-396-9842
Mailing Address - Fax:215-396-0849
Practice Address - Street 1:36 TERRY DR
Practice Address - Street 2:SUITE A
Practice Address - City:TREVOSE
Practice Address - State:PA
Practice Address - Zip Code:19053-6518
Practice Address - Country:US
Practice Address - Phone:215-396-9842
Practice Address - Fax:215-396-0849
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1281560001Medicare ID - Type Unspecified