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General NPI Number Information
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NPI Number | 1679570840
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Entity Type | Organization
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Legal Business Name | BLUE RIDGE REGIONAL HOSPITAL INC
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Dates
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Enumeration Date | 07/04/2005
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Last Update Date | 04/10/2009
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Provider Practice Location Address
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Address Line | 125 HOSPITAL DR
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City | SPRUCE PINE
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State | NC
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Zip | 28777-3035
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Country | US
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Telephone | 828-765-4201
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Fax | 828-765-0824
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Provider Business Mailing Address
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Address Line | PO BOX 9
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City | SPRUCE PINE
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State | NC
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Zip | 28777-0009
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Country | US
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Telephone | 828-765-4201
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Fax | 828-765-0824
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Authorized Official
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Title or Position | CFO
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Name | MR. JONATHAN CARL SMITH
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Credential |
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Telephone | 828-766-1740
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 282NR1301X
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Taxonomy Name | Rural Acute Care Hospital
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License Number | H0169
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License Number State | NC
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