Provider Demographics
NPI:1851547731
Name:FREEMOTION PLUS MEDICAL SUPPLY
Entity Type:Organization
Organization Name:FREEMOTION PLUS MEDICAL SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:ALEGRIA
Authorized Official - Middle Name:C
Authorized Official - Last Name:PHANKONSY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-982-3859
Mailing Address - Street 1:501 S RANCHO DR
Mailing Address - Street 2:A1
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89106-4828
Mailing Address - Country:US
Mailing Address - Phone:702-982-3859
Mailing Address - Fax:702-982-1601
Practice Address - Street 1:501 S RANCHO DR
Practice Address - Street 2:A1
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-4828
Practice Address - Country:US
Practice Address - Phone:702-982-3859
Practice Address - Fax:702-982-1601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-12
Last Update Date:2008-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies