Provider Demographics
NPI:1013327410
Name:AFFORDABLE FREEDOM MOBILITY, LLC
Entity type:Organization
Organization Name:AFFORDABLE FREEDOM MOBILITY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CONNIE
Authorized Official - Middle Name:B
Authorized Official - Last Name:BOOTHE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-593-6148
Mailing Address - Street 1:401 WALKINGSTICK WAY
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29680-7224
Mailing Address - Country:US
Mailing Address - Phone:864-593-6148
Mailing Address - Fax:
Practice Address - Street 1:401 WALKINGSTICK WAY
Practice Address - Street 2:
Practice Address - City:SIMPSONVILLE
Practice Address - State:SC
Practice Address - Zip Code:29680-7224
Practice Address - Country:US
Practice Address - Phone:864-593-6148
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-07
Last Update Date:2014-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC313-6GK343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)