Provider Demographics
NPI:1588840508
Name:MOBILITY FREEDOM, INC.
Entity Type:Organization
Organization Name:MOBILITY FREEDOM, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMPLIANCE SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:ANNMARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BUCKINGHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:234-200-1379
Mailing Address - Street 1:4199 KINROSS LAKES PKWY STE 300
Mailing Address - Street 2:
Mailing Address - City:RICHFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44286-9394
Mailing Address - Country:US
Mailing Address - Phone:234-312-2000
Mailing Address - Fax:
Practice Address - Street 1:20354 US HWY 27
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34715-8794
Practice Address - Country:US
Practice Address - Phone:352-429-3972
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-22
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No171WV0202XOther Service ProvidersContractorVehicle ModificationsGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive Care
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL4266120001Medicare NSC
FL4266120001Medicare NSC
FL4266120001OtherMEDICARE
FL678966898Medicaid