Provider Demographics
NPI:1710218854
Name:LLC PATIENT SERVICES INC
Entity Type:Organization
Organization Name:LLC PATIENT SERVICES INC
Other - Org Name:FREEDOM HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:LIVANAVAGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-889-5489
Mailing Address - Street 1:1829 W DRAKE DR STE 101
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-4320
Mailing Address - Country:US
Mailing Address - Phone:866-889-5489
Mailing Address - Fax:888-885-1938
Practice Address - Street 1:1829 W DRAKE DR STE 101
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-4320
Practice Address - Country:US
Practice Address - Phone:866-889-5489
Practice Address - Fax:888-885-1938
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-28
Last Update Date:2011-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ148655332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies