Healthcare Provider Details

I. General information

NPI: 1851334197
Provider Name (Legal Business Name): FRIES FAMILY CARE CENTER PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 07/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 CARROL DR
FRIES VA
24330-4532
US

IV. Provider business mailing address

PO BOX 453
FRIES VA
24330-0453
US

V. Phone/Fax

Practice location:
  • Phone: 276-744-3660
  • Fax: 276-744-3843
Mailing address:
  • Phone: 276-744-3660
  • Fax: 276-744-3843

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateVA

VIII. Authorized Official

Name: SHERRIE WILLIAMS
Title or Position: PRACTICE ADMINISTRATOR
Credential: RN, CPC
Phone: 276-744-3660