Healthcare Provider Details

I. General information

NPI: 1134742919
Provider Name (Legal Business Name): FREEDOM RESPIRATORY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2020
Last Update Date: 12/21/2022
Certification Date: 12/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8002 DISCOVERY DR RM 110A
RICHMOND VA
23229-8601
US

IV. Provider business mailing address

220 W GERMANTOWN PIKE STE 250
PLYMOUTH MEETING PA
19462-1437
US

V. Phone/Fax

Practice location:
  • Phone: 804-286-1842
  • Fax: 804-479-8174
Mailing address:
  • Phone: 651-402-8313
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: STEPHEN P GRIGGS
Title or Position: CEO, PRESIDENT
Credential:
Phone: 407-206-0040