Provider Demographics
NPI:1083813539
Name:FREUND BROTHERS
Entity Type:Organization
Organization Name:FREUND BROTHERS
Other - Org Name:FREUND BROS
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:HENRY
Authorized Official - Last Name:FREUND
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:609-927-0990
Mailing Address - Street 1:71 CENTRAL SQ
Mailing Address - Street 2:
Mailing Address - City:LINWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08221-2167
Mailing Address - Country:US
Mailing Address - Phone:609-927-0990
Mailing Address - Fax:
Practice Address - Street 1:71 CENTRAL SQ
Practice Address - Street 2:
Practice Address - City:LINWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08221-2167
Practice Address - Country:US
Practice Address - Phone:609-927-0990
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-15
Last Update Date:2007-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ31TD00077300332B00000X
335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0126365Medicaid
NJ0126365Medicaid