Organization
FREEDOM MEDICAL SUPPLY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CANDACE POE ATP (OWNER/ MANAGER)
(217) 422-2220
Entity
Organization
Contact information
Practice address
2525 N MAIN ST, DECATUR, IL 62526-3227
(217) 422-2220
(217) 422-2223
Mailing address
2525 N MAIN ST, DECATUR, IL 62526-3227
(217) 422-2220
(217) 422-2223
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
203000231
IL
Other
Enumeration date
06/10/2005
Last updated
04/23/2009
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