Organization
FREEDOM RESPIRATORY SOLUTIONS, LLC
Active
Parent organization
PROVIDACARE MEDICAL SUPPLY, LTD
Other names
Providacare Medical Supply
Organization subpart
Yes
Provider details
NPI number
Legal business name
PROVIDACARE MEDICAL SUPPLY, LTD
Authorized official
MR. JAMES M SHANDORF (CEO)
(218) 727-5555
Entity
Organization
Contact information
Practice address
601 HIGHWAY 10 E, DETROIT LAKES, MN 56501-4127
(218) 844-2273
(218) 844-2279
Mailing address
831 E 2ND ST, DULUTH, MN 55805-2103
(512) 733-6518
(512) 795-9185
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
—
Other
Enumeration date
12/18/2008
Last updated
01/29/2019
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