Provider Demographics
NPI:1881483444
Name:FREEDOM WOUND CARE LLC
Entity type:Organization
Organization Name:FREEDOM WOUND CARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:SHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:FERRERIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-663-7167
Mailing Address - Street 1:2626 S RAINBOW BLVD STE 203
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-5190
Mailing Address - Country:US
Mailing Address - Phone:805-663-7167
Mailing Address - Fax:
Practice Address - Street 1:2626 S RAINBOW BLVD STE 203
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-5190
Practice Address - Country:US
Practice Address - Phone:805-663-7167
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-01
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty