=====================================================
General NPI Number Information
=====================================================
NPI Number | 1356541403
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NEW FREEDOM TRANSPORTATION, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/18/2007
-----------------------------------------------------
Last Update Date | 07/18/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6011 NINE MILE RD
-----------------------------------------------------
City | RICHMOND
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23223-3550
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 804-328-2340
-----------------------------------------------------
Fax | 804-328-2334
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 13807 VILLAGE MILL DR STE 301
-----------------------------------------------------
City | MIDLOTHIAN
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23114-4361
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 804-328-2340
-----------------------------------------------------
Fax | 804-328-2334
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | B. J. BATCHELOR
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 804-241-0949
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 343900000X
-----------------------------------------------------
Taxonomy Name | Non-emergency Medical Transport (VAN)
-----------------------------------------------------
License Number | 60
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------