Healthcare Provider Details

I. General information

NPI: 1679570840
Provider Name (Legal Business Name): BLUE RIDGE REGIONAL HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/04/2005
Last Update Date: 04/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 HOSPITAL DR
SPRUCE PINE NC
28777-3035
US

IV. Provider business mailing address

PO BOX 9
SPRUCE PINE NC
28777-0009
US

V. Phone/Fax

Practice location:
  • Phone: 828-765-4201
  • Fax: 828-765-0824
Mailing address:
  • Phone: 828-765-4201
  • Fax: 828-765-0824

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code282NR1301X
TaxonomyRural Acute Care Hospital
License NumberH0169
License Number StateNC

VIII. Authorized Official

Name: MR. JONATHAN CARL SMITH
Title or Position: CFO
Credential:
Phone: 828-766-1740