MEDICARE: FREEDOM DME, 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	L07000087106	FL

General Provider Information

NPI Number	:	1649457243
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FREEDOM DME, LLC

Provider Business Mailing Address
First Line	:	7637 HEYWARD CIR
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34201-2050
Country	:	US
Telephone Number	:	941-587-5803
Fax Number	:

Provider Business Practice Location Address
First Line	:	7637 HEYWARD CIR
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34201-2050
Country	:	US
Telephone Number	:	941-587-5803
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	STEVE EKES
Credential	:	PT
Telephone Number	:	941-587-5803

Provider Enumeration Date	:	01/25/2008
Last Update Date	:	04/20/2008

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