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General NPI Number Information
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NPI Number | 1093789943
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Entity Type | Organization
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Legal Business Name | FREEDOM ACCESS & MOBILITY LLC
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Dates
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Enumeration Date | 02/16/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1222 GREENBAY RD
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City | MORGANTOWN
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State | WV
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Zip | 26505
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Country | US
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Telephone | 304-296-8286
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Fax | 304-225-3922
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Provider Business Mailing Address
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Address Line | PO BOX 4131
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City | STAR CITY
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State | WV
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Zip | 26504
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Country | US
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Telephone | 304-296-8286
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Fax | 304-225-3922
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Authorized Official
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Title or Position | OWNER OPERATOR
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Name | MR. RICHARD V CONNELL JR.
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Credential | OWNER
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Telephone | 304-296-8286
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 001
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License Number State | WV
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