Provider Demographics
NPI:1477536506
Name:FREEDOM MEDICAL LLC
Entity Type:Organization
Organization Name:FREEDOM MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:R
Authorized Official - Last Name:BURFOOT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-524-1451
Mailing Address - Street 1:268 N MAIN ST
Mailing Address - Street 2:STE 2
Mailing Address - City:ST ALBANS
Mailing Address - State:VT
Mailing Address - Zip Code:05478-2500
Mailing Address - Country:US
Mailing Address - Phone:802-524-1451
Mailing Address - Fax:802-524-0975
Practice Address - Street 1:268 N MAIN ST
Practice Address - Street 2:STE 2
Practice Address - City:ST ALBANS
Practice Address - State:VT
Practice Address - Zip Code:05478-2500
Practice Address - Country:US
Practice Address - Phone:802-524-1451
Practice Address - Fax:802-524-0975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT4693408OtherCIGNA PROV NUMBER
VT553990OtherNH CIGNA PROV NUMBER
VTFREE59589OtherBCBS VT PROV NUMBER
VT1009657Medicaid
VT88890OtherMVP PROV NUMBER
VT5565060001Medicare NSC