Organization
FREEDOM CARS MOBILITY STORE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CLARKE A MCKINNEY (OWNER)
(651) 429-6323
Entity
Organization
Contact information
Practice address
4711 CLARK AVE, WHITE BEAR LAKE, MN 55110-3268
(651) 429-6323
(651) 429-0308
Mailing address
4711 CLARK AVE, WHITE BEAR LAKE, MN 55110-3268
(651) 429-6323
(651) 429-0308
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
8139026
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
303L9MC
BLUE CROSS CLUE SHIELD
MN
Enumeration date
02/08/2007
Last updated
11/02/2007
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