Provider Demographics
NPI:1932649142
Name:FREEDOM EMS
Entity Type:Organization
Organization Name:FREEDOM EMS
Other - Org Name:FREEDOM EMS LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:REGINALD
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:470-771-8184
Mailing Address - Street 1:5459 NORTH HENRY BLVD
Mailing Address - Street 2:SUITE D
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281
Mailing Address - Country:US
Mailing Address - Phone:470-771-8184
Mailing Address - Fax:470-771-8185
Practice Address - Street 1:5459 N HENRY BLVD STE D
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-3265
Practice Address - Country:US
Practice Address - Phone:470-771-8184
Practice Address - Fax:470-771-8185
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAMB2017006341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance