MEDICARE: FREEDOM MANAGEMENT GROUP, LLC

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	332B00000X	Durable Medical Equipment & Medical Supplies

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174593834
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FREEDOM MANAGEMENT GROUP, LLC

Provider Business Mailing Address
First Line	:	1845 W RENO AVE # B
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73106-3217
Country	:	US
Telephone Number	:	405-228-0911
Fax Number	:	405-228-0942

Provider Business Practice Location Address
First Line	:	1845 W RENO AVE # B
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73106-3217
Country	:	US
Telephone Number	:	405-228-0911
Fax Number	:	405-228-0942

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. AMY LYN HOOVER
Credential	:
Telephone Number	:	405-228-0911

Provider Enumeration Date	:	01/25/2006
Last Update Date	:	08/12/2014

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