Mobile Freedom LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

MOBILE FREEDOM LLC

Practice address

940 North Hermitage Road
Hermitage, PA 16148

Phone

(724) 981-2165

Fax

(724) 981-2857

NPI assigned

May 25, 2006

Organization subpart

No

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

Authorized official

Name

Mr. David John Venerose Jr.

Title

Pres Ceo Owner

Phone

(724) 981-2165

Specialties & licenses 1

Addresses

Other identifiers 4

Locations

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1275589988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "940 NORTH HERMITAGE ROAD",
            "city": "HERMITAGE",
            "state": "PA",
            "postal_code": "16148",
            "telephone_number": "724-981-2165",
            "fax_number": "724-981-2857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 NORTH HERMITAGE ROAD",
            "city": "HERMITAGE",
            "state": "PA",
            "postal_code": "16148",
            "telephone_number": "724-981-2165",
            "fax_number": "724-981-2857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILE FREEDOM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VENEROSE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "PRES CEO OWNER",
        "authorized_official_telephone_number": "724-981-2165",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1014298120001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID",
            "identifier": "2603810",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID",
            "identifier": "38100041168861",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02672599",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Hermitage, PA
• Providers in Hermitage, PA by specialty
• Durable Medical Equipment & Medical Supplies in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.