Healthcare Provider Details

I. General information

NPI: 1508009788
Provider Name (Legal Business Name): BLUE RIDGE REGIONAL HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2009
Last Update Date: 07/07/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 HOSPITAL DR PO DRAWER 9
SPRUCE PINE NC
28777-3035
US

IV. Provider business mailing address

PO DRAWER 9
SPRUCE PINE NC
28777
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: LISA ANN STHAY
Title or Position: VP PHYSICIAN SERVICES
Credential: RN
Phone: 828-766-1700