Healthcare Provider Details

I. General information

NPI: 1073265724
Provider Name (Legal Business Name): FREEDOM HOME HEALTH CARE AGENCY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2022
Last Update Date: 07/19/2023
Certification Date: 07/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2424 E YORK ST UNIT 100-E
PHILADELPHIA PA
19125-3026
US

IV. Provider business mailing address

2424 E YORK ST UNIT 100-E
PHILADELPHIA PA
19125-3026
US

V. Phone/Fax

Practice location:
  • Phone: 215-834-2865
  • Fax: 267-855-9317
Mailing address:
  • Phone: 215-834-2865
  • Fax: 267-855-9317

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: SUREN AIRAPETIAN
Title or Position: PRESIDENT
Credential: RN
Phone: 215-834-2865