MEDICARE: FREEDOM MOBILITY, 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
2	146D00000X	Personal Emergency Response Attendant

General Provider Information

NPI Number	:	1285127324
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FREEDOM MOBILITY, LLC

Provider Business Mailing Address
First Line	:	7271 PARK CIRCLE DR STE 100
Second Line	:
City	:	HANOVER
State	:	MD
Zip	:	21076-1325
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7271 PARK CIRCLE DR STE 100
Second Line	:
City	:	HANOVER
State	:	MD
Zip	:	21076-1325
Country	:	US
Telephone Number	:	443-445-3518
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	BRAD WINE
Credential	:
Telephone Number	:	443-445-3518

Provider Enumeration Date	:	06/13/2018
Last Update Date	:	03/30/2023

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