MEDICARE: FREEHOLD DME INC

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

General Provider Information

NPI Number	:	1194226878
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FREEHOLD DME INC

Provider Business Mailing Address
First Line	:	31 W MAIN ST
Second Line	:
City	:	FREEHOLD
State	:	NJ
Zip	:	07728-2463
Country	:	US
Telephone Number	:	732-333-0275
Fax Number	:

Provider Business Practice Location Address
First Line	:	31 W MAIN ST
Second Line	:
City	:	FREEHOLD
State	:	NJ
Zip	:	07728-2463
Country	:	US
Telephone Number	:	732-333-0275
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	EKATERINA ANDREEVA
Credential	:
Telephone Number	:	732-333-0275

Provider Enumeration Date	:	02/27/2018
Last Update Date	:	02/27/2018

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