Healthcare Provider Details

I. General information

NPI: 1093811598
Provider Name (Legal Business Name): BLUE RIDGE WOMEN'S HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2006
Last Update Date: 01/04/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1885 PORT REPUBLIC RD
HARRISONBURG VA
22801-3533
US

IV. Provider business mailing address

1885 PORT REPUBLIC RD
HARRISONBURG VA
22801-3533
US

V. Phone/Fax

Practice location:
  • Phone: 540-433-6613
  • Fax: 540-433-6605
Mailing address:
  • Phone: 540-433-6613
  • Fax: 540-433-6605

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number0101029047
License Number StateVA

VIII. Authorized Official

Name: RICHARD E.N. SEDWICK
Title or Position: DIRECTOR
Credential:
Phone: 540-433-6613