Provider Demographics
NPI:1255320164
Name:FREEDOM2GO LLC
Entity Type:Organization
Organization Name:FREEDOM2GO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:A
Authorized Official - Last Name:LAMB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:325-437-2382
Mailing Address - Street 1:PO BOX 2802
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79604-2802
Mailing Address - Country:US
Mailing Address - Phone:325-437-2382
Mailing Address - Fax:325-437-2388
Practice Address - Street 1:2400 CROCKETT DRIVE STE 300
Practice Address - Street 2:
Practice Address - City:BROWNWOOD
Practice Address - State:TX
Practice Address - Zip Code:76801-1705
Practice Address - Country:US
Practice Address - Phone:325-646-1520
Practice Address - Fax:325-646-1141
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-14
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX530729OtherBCBS
TX017133201Medicaid
TX111394603Medicaid
1268500002Medicare ID - Type Unspecified