Freddie Dean Vines | Newport News, VA • PECOS Search

Freddie Dean Vines

Social Worker

Behavioral Health & Social Service Providers

703 Thimble Shoals Blvd, A-3, Newport News, VA 23606-2576

PECOS Enrollment

Based on the most recent information from CMS, provider Freddie Dean Vines does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1366411290
Provider Type
Individual
Full Name
Vines, Freddie Dean
Gender
Male

Sole Proprietor
No
Enumeration Date
3/14/2006
Last Updated
1/17/2008

Contact Information

Practice Location

703 Thimble Shoals Blvd, A-3, Newport News, VA 23606-2576

Unlisted Fax

Mailing Location

8589 E Creek Ln, Hayes, VA 23072-3748

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License 0904002078 Virginia