| NPI | 1962025502 |
|---|---|
| Former Legal Business Name | MEDFRES, INC |
| Entity Type | Organization |
| Authorized Contact | CHARLES E ARCHIE Hr 757-850-0614 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QV0200X Clinic/Center, VA |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| 261QP2300X Clinic/Center, Primary Care | |
| Enumeration Date | 2020-05-18 |
| Last Update Date | 2026-07-30 |