Healthcare Provider Details

I. General information

NPI: 1306843651
Provider Name (Legal Business Name): BLUE RIDGE HOSPICE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2005
Last Update Date: 04/14/2025
Certification Date: 04/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 W CORK ST #405
WINCHESTER VA
22601-3870
US

IV. Provider business mailing address

333 W CORK ST #405
WINCHESTER VA
22601-3870
US

V. Phone/Fax

Practice location:
  • Phone: 540-313-9200
  • Fax: 540-678-0772
Mailing address:
  • Phone: 540-313-9200
  • Fax: 540-678-0772

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number050315
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number1103813
License Number StateVA

VIII. Authorized Official

Name: STEPHEN PAUL JONES
Title or Position: DIR. COMPLIANCE, QUALITY, & EDUCATI
Credential:
Phone: 540-313-9200