MEDICARE: FREEDOM MEDICAL SUPPLIES

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	R2563	MD

General Provider Information

NPI Number	:	1730215666
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FREEDOM MEDICAL SUPPLIES

Provider Business Mailing Address
First Line	:	1005 SAMPLERS WAY
Second Line	:
City	:	POTOMAC
State	:	MD
Zip	:	20854-2940
Country	:	US
Telephone Number	:	301-788-6962
Fax Number	:	301-333-3633

Provider Business Practice Location Address
First Line	:	9244 EAST HAMPTON DRIVE, SUITE 110
Second Line	:
City	:	CAPITOL HEIGHTS
State	:	MD
Zip	:	20743-3829
Country	:	US
Telephone Number	:	301-333-9000
Fax Number	:	301-333-3633

Authorized Official
Title or Position	:	OWNER
Name	:	DR. RAHAT JAHAN KHAN
Credential	:	PH.D
Telephone Number	:	301-788-6962

Provider Enumeration Date	:	02/26/2007
Last Update Date	:	01/05/2009

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