Healthcare Provider Details

I. General information

NPI: 1720556269
Provider Name (Legal Business Name): MH BLUE RIDGE MEDICAL CENTER, LLLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2018
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

189 HOSPITAL DR
SPRUCE PINE NC
28777-3035
US

IV. Provider business mailing address

189 HOSPITAL DR
SPRUCE PINE NC
28777-3035
US

V. Phone/Fax

Practice location:
  • Phone: 828-213-4444
  • Fax:
Mailing address:
  • Phone: 828-766-3555
  • Fax: 828-765-5877

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: TYLER GOESSER
Title or Position: CFO
Credential:
Phone: 828-277-4818