Provider Demographics
NPI:1730215666
Name:FREEDOM MEDICAL SUPPLIES
Entity type:Organization
Organization Name:FREEDOM MEDICAL SUPPLIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAHAT
Authorized Official - Middle Name:JAHAN
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:301-788-6962
Mailing Address - Street 1:1005 SAMPLERS WAY
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-2940
Mailing Address - Country:US
Mailing Address - Phone:301-788-6962
Mailing Address - Fax:301-333-3633
Practice Address - Street 1:9244 EAST HAMPTON DRIVE, SUITE 110
Practice Address - Street 2:
Practice Address - City:CAPITOL HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20743-3829
Practice Address - Country:US
Practice Address - Phone:301-333-9000
Practice Address - Fax:301-333-3633
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2009-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR2563332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD6023270001Medicare NSC