Healthcare Provider Details

I. General information

NPI: 1184057481
Provider Name (Legal Business Name): FREEDOM HEALTHCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2013
Last Update Date: 07/12/2025
Certification Date: 07/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1119 E MONUMENT ST
BALTIMORE MD
21202
US

IV. Provider business mailing address

3310 EASTERN AVE
BALTIMORE MD
21224-4108
US

V. Phone/Fax

Practice location:
  • Phone: 667-770-6320
  • Fax: 667-770-6320
Mailing address:
  • Phone: 667-770-6320
  • Fax: 667-770-6320

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. VERNON HOLMES JR.
Title or Position: CEO
Credential: MBA
Phone: 667-770-6320