Provider Demographics
NPI:1730835232
Name:FREEDOM SCIENTIFIC DIAGNOSTICS LLC
Entity type:Organization
Organization Name:FREEDOM SCIENTIFIC DIAGNOSTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:ROD
Authorized Official - Middle Name:
Authorized Official - Last Name:BLOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-809-5084
Mailing Address - Street 1:417 E BALTIMORE ST STE F1
Mailing Address - Street 2:
Mailing Address - City:TANEYTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21787-2300
Mailing Address - Country:US
Mailing Address - Phone:908-809-5084
Mailing Address - Fax:
Practice Address - Street 1:417 E BALTIMORE ST STE F1
Practice Address - Street 2:
Practice Address - City:TANEYTOWN
Practice Address - State:MD
Practice Address - Zip Code:21787-2300
Practice Address - Country:US
Practice Address - Phone:443-971-1522
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-23
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory