Provider Demographics
NPI:1669751277
Name:GARY HARRIS DBA FREEDOM TRANSIT
Entity type:Organization
Organization Name:GARY HARRIS DBA FREEDOM TRANSIT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-927-0047
Mailing Address - Street 1:5900 W 62ND TER
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66202-3526
Mailing Address - Country:US
Mailing Address - Phone:913-927-0047
Mailing Address - Fax:
Practice Address - Street 1:5900 W 62ND TER
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:KS
Practice Address - Zip Code:66202-3526
Practice Address - Country:US
Practice Address - Phone:913-927-0047
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-12
Last Update Date:2011-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSK02-10-6091343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)