Healthcare Provider Details

I. General information

NPI: 1730559329
Provider Name (Legal Business Name): BLUE RIDGE MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2015
Last Update Date: 10/22/2025
Certification Date: 10/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4038 THOMAS NELSON HWY
ARRINGTON VA
22922-2302
US

IV. Provider business mailing address

4038 THOMAS NELSON HWY
ARRINGTON VA
22922-2302
US

V. Phone/Fax

Practice location:
  • Phone: 434-263-4000
  • Fax: 434-263-4160
Mailing address:
  • Phone: 434-263-4000
  • Fax: 434-263-4160

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number0201003758
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number0201003758
License Number StateVA

VIII. Authorized Official

Name: RODNEY JOHNSON
Title or Position: CEO
Credential:
Phone: 434-263-4000