# FREEDOM RESPIRATORY SOLUTIONS, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PROVIDACARE MEDICAL SUPPLY, LTD
- **Other names:** Providacare Medical Supply
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1023254216
- **Legal business name:** PROVIDACARE MEDICAL SUPPLY, LTD
- **Authorized official:** MR. JAMES M SHANDORF (CEO)
- **Authorized official phone:** (218) 727-5555

## Contact information

- **Practice address:** 601 HIGHWAY 10 E, DETROIT LAKES, MN 56501-4127
- **Practice address phone:** (218) 844-2273
- **Practice address fax:** (218) 844-2279
- **Mailing address:** 831 E 2ND ST, DULUTH, MN 55805-2103
- **Mailing address phone:** (512) 733-6518
- **Mailing address fax:** (512) 795-9185

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332BX2000X | Oxygen Equipment & Supplies (DME) | — | NULL | Yes |

## Other

- **Enumeration date:** 12/18/2008
- **Last updated:** 01/29/2019