Healthcare Provider Details

I. General information

NPI: 1538564596
Provider Name (Legal Business Name): BLUE RIDGE PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2014
Last Update Date: 08/01/2026
Certification Date: 08/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 LONG SHOALS RD STE 100
ARDEN NC
28704-8432
US

IV. Provider business mailing address

106 LONG SHOALS RD STE 100
ARDEN NC
28704-8432
US

V. Phone/Fax

Practice location:
  • Phone: 828-707-9700
  • Fax: 877-654-3477
Mailing address:
  • Phone: 828-707-9700
  • Fax: 828-707-9705

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DR. ROBERT DEAN CLAYTON
Title or Position: CFO/COO
Credential: PHARM.D.
Phone: 828-707-9700