New Freedom Healthcare LLC

Primary specialty

Dialysis Equipment & Supplies (DME)Taxonomy code 332BD1200X

Legal business name

NEW FREEDOM HEALTHCARE LLC

Practice address

1306 Stone St
Jonesboro, AR 72401-4522

Phone

(870) 336-0606

Fax

(870) 336-2265

NPI assigned

Apr 12, 2007

Last updated

Apr 27, 2009By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Otis W Willey

Title

Owner

Phone

(870) 336-0606

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240790400000",
    "number": "1114141165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1306 STONE ST",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724014522",
            "telephone_number": "870-336-0606",
            "fax_number": "870-336-2265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1306 STONE ST",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724014522",
            "telephone_number": "870-336-0606",
            "fax_number": "870-336-2265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW FREEDOM HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-12",
        "last_updated": "2009-04-27",
        "status": "A",
        "authorized_official_last_name": "WILLEY",
        "authorized_official_first_name": "OTIS",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "870-336-0606",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332BD1200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Dialysis Equipment & Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "167533716",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.