MEDICARE: FREEDOM GUARD HOME SAFETY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1295551570
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FREEDOM GUARD HOME SAFETY LLC

Provider Business Mailing Address
First Line	:	3612 RED FIR ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89135-2864
Country	:	US
Telephone Number	:	702-530-4038
Fax Number	:	702-602-7578

Provider Business Practice Location Address
First Line	:	3612 RED FIR ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89135-2864
Country	:	US
Telephone Number	:	702-530-4038
Fax Number	:	702-602-7578

Authorized Official
Title or Position	:	OWNER
Name	:	MATTHEW DARLING
Credential	:
Telephone Number	:	702-530-4038

Provider Enumeration Date	:	12/02/2024
Last Update Date	:	12/02/2024

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