Healthcare Provider Details

I. General information

NPI: 1700905510
Provider Name (Legal Business Name): BLUE RIDGE HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2007
Last Update Date: 07/23/2021
Certification Date: 07/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2348 HIGHWAY 105 SOUTH UNIT # 11
BOONE NC
28607-7802
US

IV. Provider business mailing address

PO BOX 532588
ATLANTA GA
30353-2588
US

V. Phone/Fax

Practice location:
  • Phone: 828-262-5656
  • Fax: 828-262-0480
Mailing address:
  • Phone: 843-821-8525
  • Fax: 843-821-0982

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number070235
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number070235
License Number StateNC

VIII. Authorized Official

Name: MR. GREG MCCARTHY
Title or Position: COO
Credential:
Phone: 727-530-7700