MEDICARE: SCOTT GARTH FREEMAN SCOTT FREEMAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	146N00000X	Basic Emergency Medical Technician	098818	PA
2	156FX1800X	Optician

General Provider Information

NPI Number	:	1164413126
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SCOTT GARTH FREEMAN SCOTT FREEMAN

Provider Business Mailing Address
First Line	:	8896 CLEARWATER CIR
Second Line	:
City	:	FOGELSVILLE
State	:	PA
Zip	:	18051-2046
Country	:	US
Telephone Number	:	610-285-4245
Fax Number	:

Provider Business Practice Location Address
First Line	:	8896 CLEARWATER CIR
Second Line	:
City	:	FOGELSVILLE
State	:	PA
Zip	:	18051-2046
Country	:	US
Telephone Number	:	610-285-4245
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/31/2005
Last Update Date	:	09/11/2025

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