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General NPI Number Information
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NPI Number | 1013327410
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Entity Type | Organization
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Legal Business Name | AFFORDABLE FREEDOM MOBILITY, LLC
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Dates
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Enumeration Date | 05/07/2014
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Last Update Date | 05/07/2014
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Provider Practice Location Address
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Address Line | 401 WALKINGSTICK WAY
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City | SIMPSONVILLE
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State | SC
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Zip | 29680-7224
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Country | US
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Telephone | 864-593-6148
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Fax |
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Provider Business Mailing Address
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Address Line | 401 WALKINGSTICK WAY
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City | SIMPSONVILLE
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State | SC
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Zip | 29680-7224
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Country | US
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Telephone | 864-593-6148
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Fax |
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | MS. CONNIE B BOOTHE
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Credential |
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Telephone | 864-593-6148
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number | 313-6GK
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License Number State | SC
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