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General NPI Number Information
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NPI Number | 1891884748
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Entity Type | Organization
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Legal Business Name | BLUE RIDGE HEALTHCARE MEDICAL GROUP, INC.
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Dates
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Enumeration Date | 10/11/2006
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Last Update Date | 03/12/2025
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Provider Practice Location Address
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Address Line | 2201 S. STERLING ST.
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City | MORGANTON
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State | NC
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Zip | 28655
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Country | US
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Telephone | 828-580-6403
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Fax | 828-580-4049
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Provider Business Mailing Address
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Address Line | 2201 S STERLING ST
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City | MORGANTON
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State | NC
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Zip | 28655-4044
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Country | US
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Telephone | 828-580-6393
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Fax | 828-580-6399
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Authorized Official
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Title or Position | SVP/CFO
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Name | PATRICIA MOLL
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Credential |
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Telephone | 828-580-5003
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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