Healthcare Provider Details
I. General information
NPI: 1659798361
Provider Name (Legal Business Name): BLUE RIDGE PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/20/2014
Last Update Date: 08/29/2025
Certification Date: 08/29/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
805 FAIRVIEW RD SUITE 100
ASHEVILLE NC
28803-1011
US
IV. Provider business mailing address
805 FAIRVIEW RD SUITE 100
ASHEVILLE NC
28803-1011
US
V. Phone/Fax
- Phone: 828-298-3636
- Fax: 828-298-8190
- Phone: 828-298-3636
- Fax: 828-298-8190
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 183500000X |
| Taxonomy | Pharmacist |
| License Number | 9136 |
| License Number State | NC |
VIII. Authorized Official
Name: DR.
ROBERT
DEAN
CLAYTON
Title or Position: OWNER/CFO
Credential: PHARM.D.
Phone: 828-298-3636