Healthcare Provider Details

I. General information

NPI: 1750621603
Provider Name (Legal Business Name): BLUE RIDGE COMMUNITY HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2013
Last Update Date: 09/08/2025
Certification Date: 09/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29 W FRENCH BROAD ST STE 202
BREVARD NC
28712-4773
US

IV. Provider business mailing address

PO BOX 5151
HENDERSONVILLE NC
28793-5151
US

V. Phone/Fax

Practice location:
  • Phone: 828-883-5550
  • Fax:
Mailing address:
  • Phone: 828-692-4289
  • Fax: 828-696-1794

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: TAMMY R GREENWELL
Title or Position: CEO
Credential:
Phone: 828-233-2284