Organization
MOBILE FREEDOM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID JOHN VENEROSE JR. (PRES CEO OWNER)
(724) 981-2165
Entity
Organization
Contact information
Practice address
940 NORTH HERMITAGE ROAD, HERMITAGE, PA 16148
(724) 981-2165
(724) 981-2857
Mailing address
940 NORTH HERMITAGE ROAD, HERMITAGE, PA 16148
(724) 981-2165
(724) 981-2857
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02672599
—
NY
05
—
1014298120001
—
PA
01
—
2603810
MEDICAID
OH
01
—
38100041168861
MEDICAID
WV
Enumeration date
05/25/2006
Last updated
08/22/2020
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