Healthcare Provider Details

I. General information

NPI: 1689311441
Provider Name (Legal Business Name): BLUE RIDGE PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2022
Last Update Date: 09/13/2024
Certification Date: 09/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

805 FAIRVIEW RD STE 100
ASHEVILLE NC
28803-1011
US

IV. Provider business mailing address

805 FAIRVIEW RD STE 100
ASHEVILLE NC
28803-1011
US

V. Phone/Fax

Practice location:
  • Phone: 828-298-3636
  • Fax:
Mailing address:
  • Phone: 828-298-3636
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: NATASHA MATHENY MICHAELS
Title or Position: VP OF CLINICAL OPERATIONS
Credential:
Phone: 828-298-3636