MEDICARE: FEDSERVE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	261QM0850X	Adult Mental Health Clinic/Center
2	261QH0100X	Health Service Clinic/Center
3	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1881308682
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FEDSERVE

Provider Business Mailing Address
First Line	:	8003 FRANKLIN FARMS DR RM 102
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23229-5107
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8003 FRANKLIN FARMS DR RM 102
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23229-5107
Country	:	US
Telephone Number	:	301-841-5077
Fax Number	:

Authorized Official
Title or Position	:	MANAGING DIRECTOR
Name	:	DANIEL ODUKOYA
Credential	:
Telephone Number	:	301-841-5077

Provider Enumeration Date	:	01/06/2023
Last Update Date	:	09/04/2024

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Directions to “FEDSERVE ” Practice Location

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