Freedom Cars Mobility Store

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

8139026 Issued in MN

Legal business name

FREEDOM CARS MOBILITY STORE

Practice address

4711 Clark Ave
White Bear Lake, MN 55110-3268

Phone

(651) 429-6323

Fax

(651) 429-0308

NPI assigned

Feb 8, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Clarke A McKinney

Title

Owner

Phone

(651) 429-6323

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193961600000",
    "number": "1992846406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4711 CLARK AVE",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551103268",
            "telephone_number": "651-429-6323",
            "fax_number": "651-429-0308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4711 CLARK AVE",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551103268",
            "telephone_number": "651-429-6323",
            "fax_number": "651-429-0308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREEDOM CARS MOBILITY STORE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-08",
        "last_updated": "2007-11-02",
        "status": "A",
        "authorized_official_last_name": "MCKINNEY",
        "authorized_official_first_name": "CLARKE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "651-429-6323",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MN",
            "license": "8139026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS CLUE SHIELD",
            "identifier": "303L9MC",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erin Ernestine Forsman, M.S.W., LICSW
• Francine Fox
• Rebecca R Fraenkel, LP
• Elaine M Francis, MD
• Alex Thomas Fredrickson, MD
• Alaysia Freetly
• Jill Marie Friedrichs, D.C.
• Jennifer Marie Frison, OTR/L
• Jillian Alexxis Garies
• Margaret Gast, MD

• Durable Medical Equipment & Medical Supplies in White Bear Lake, MN
• Providers in White Bear Lake, MN by specialty
• Durable Medical Equipment & Medical Supplies in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2007; 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.