MEDICARE: BLOWING ROCK HOSPITAL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QU0200X	Urgent Care Clinic/Center
2	291U00000X	Clinical Medical Laboratory
3	275N00000X	Medicare Defined Swing Bed Hospital Unit
4	261QA0600X	Adult Day Care Clinic/Center
5	261QC0050X	Critical Access Hospital Clinic/Center
6	261QE0002X	Emergency Care Clinic/Center
7	261QP2000X	Physical Therapy Clinic/Center
8	261QR0400X	Rehabilitation Clinic/Center
9	282NC0060X	Critical Access Hospital	H0160	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3414822	OTHER	NC	NCPDP NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326018649
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLOWING ROCK HOSPITAL

Provider Business Mailing Address
First Line	:	418 CHESTNUT CIR
Second Line	:	P.P. BOX 148
City	:	BLOWING ROCK
State	:	NC
Zip	:	28605-9216
Country	:	US
Telephone Number	:	828-295-3136
Fax Number	:

Provider Business Practice Location Address
First Line	:	418 CHESTNUT CIR
Second Line	:
City	:	BLOWING ROCK
State	:	NC
Zip	:	28605-9216
Country	:	US
Telephone Number	:	828-295-3136
Fax Number	:

Authorized Official
Title or Position	:	SR VP MEDICAL STAFF SERVICES
Name	:	MRS. MARY ETTA LONG
Credential	:	RHIA-CPMSM
Telephone Number	:	828-262-4133

Provider Enumeration Date	:	01/26/2006
Last Update Date	:	08/28/2013

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Directions to “BLOWING ROCK HOSPITAL ” Practice Location

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