Healthcare Provider Details

I. General information

NPI: 1275469371
Provider Name (Legal Business Name): BLUE RIDGE COMMUNITY HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 AIRPORT RD
ARDEN NC
28704-8402
US

IV. Provider business mailing address

303 AIRPORT RD
ARDEN NC
28704-8402
US

V. Phone/Fax

Practice location:
  • Phone: 828-692-4289
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: GWENDOLEN ERNESTY
Title or Position: CPO
Credential: RPH
Phone: 828-692-4289