Provider Demographics
NPI:1093139313
Name:FREEDOM PATHOLOGY PARTNERS LLC
Entity Type:Organization
Organization Name:FREEDOM PATHOLOGY PARTNERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:E
Authorized Official - Last Name:GLOSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-451-3789
Mailing Address - Street 1:524 E ELM ST
Mailing Address - Street 2:
Mailing Address - City:CONSHOHOCKEN
Mailing Address - State:PA
Mailing Address - Zip Code:19428-1913
Mailing Address - Country:US
Mailing Address - Phone:610-828-7100
Mailing Address - Fax:610-828-1360
Practice Address - Street 1:524 E ELM ST STE A
Practice Address - Street 2:
Practice Address - City:CONSHOHOCKEN
Practice Address - State:PA
Practice Address - Zip Code:19428-1913
Practice Address - Country:US
Practice Address - Phone:610-941-7284
Practice Address - Fax:610-465-8962
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-06
Last Update Date:2018-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA39D2071808291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory