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FREEDOM TRANSPORTATION, LLC
Complete NPI Record 1710444997
Non-emergency Medical Transport (VAN) in Prior Lake, MN

NPI Status: Active since February 25, 2019

Contact Information

17242 HORIZON TRL SE
PRIOR LAKE, MN
ZIP 55372
Phone: (612) 830-8301

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Table of Contents

  1. NPI
  2. Entity Type Code
  3. Employer Identification Number EIN
  4. Provider Organization Name Legal Business Name
  5. Provider First Line Business Mailing Address
  6. Provider Business Mailing Address City Name
  7. Provider Business Mailing Address State Name
  8. Provider Business Mailing Address Postal Code
  9. Provider Business Mailing Address Country Code If outside U S
  10. Provider Business Mailing Address Telephone Number
  11. Provider First Line Business Practice Location Address
  12. Provider Business Practice Location Address City Name
  13. Provider Business Practice Location Address State Name
  14. Provider Business Practice Location Address Postal Code
  15. Provider Business Practice Location Address Country Code If outside U S
  16. Provider Business Practice Location Address Telephone Number
  17. Provider Enumeration Date
  18. Last Update Date
  19. Authorized Official Last Name
  20. Authorized Official First Name
  21. Authorized Official Middle Name
  22. Authorized Official Title or Position
  23. Authorized Official Telephone Number
  24. Healthcare Provider Taxonomy Code 1
  25. Healthcare Provider Primary Taxonomy Switch 1
  26. Other Provider Identifier 1
  27. Other Provider Identifier Type Code 1
  28. Other Provider Identifier State 1
  29. Is Organization Subpart

Complete NPI Dataset

This page represents the complete record for NPI 1710444997. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1710444997
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code: 2
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Employer Identification Number EIN: UNAVAIL
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider First Line Business Mailing Address: 17242 HORIZON TRL SE
The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Mailing Address City Name: PRIOR LAKE
The city name in the location address of the provider being identified.
Provider Business Mailing Address State Name: MN
The State code in the location of the provider being identified.
Provider Business Mailing Address Postal Code: 553723939
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Mailing Address Country Code If outside U S : US
The country code in the location address of the provider being identified.
Provider Business Mailing Address Telephone Number: 6128308301
The telephone number associated with the location address of the provider being identified.
Provider First Line Business Practice Location Address: 17242 HORIZON TRL SE
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name: PRIOR LAKE
The date that a record was last updated or changed.
Provider Business Practice Location Address State Name: MN
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 553723939
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 6128308301
The telephone number associated with the location address of the provider being identified.
Provider Enumeration Date: 2/25/2019
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No
Last Update Date: 3/6/2019
The date that a record was last updated or changed.
Authorized Official Last Name: SHEA
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First Name: LORI
The first name of the authorized official.
Authorized Official Middle Name: L
The middle name of the authorized official.
Authorized Official Title or Position: OWNER
The title or position of the authorized official.
Authorized Official Telephone Number: 6123808301
Healthcare Provider Taxonomy Code 1: 343900000X
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No
Healthcare Provider Primary Taxonomy Switch 1: Y
Other Provider Identifier 1: T010234994001
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 1: 05
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 1: MN
Is Organization Subpart: N