Healthcare Provider Details

I. General information

NPI: 1053309948
Provider Name (Legal Business Name): FREEDOM HOME HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2005
Last Update Date: 06/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5930 WILCOX PL SUITE D
DUBLIN OH
43016-6804
US

IV. Provider business mailing address

5930 WILCOX PL SUITE D
DUBLIN OH
43016-6804
US

V. Phone/Fax

Practice location:
  • Phone: 614-336-8870
  • Fax: 614-336-8879
Mailing address:
  • Phone: 614-336-8870
  • Fax: 614-336-8879

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number368113
License Number StateOH

VIII. Authorized Official

Name: DAVID LARSEN
Title or Position: PARTNER
Credential:
Phone: 614-336-8870