BLUE RIDGE PHYSICAL MEDICINE NPI 1710173679

NPI Information

NPI: 1710173679
Provider Name: BLUE RIDGE PHYSICAL MEDICINE
Classification: Clinic/Center - 261QP3300X
Entity Type: Organization

Specialization: Pain

Address:
4582 FRANKLIN RD SW
ROANOKE, VA
ZIP 24014
Phone: (540) 772-8052
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BLUE RIDGE PHYSICAL MEDICINE is a pain clinic center in Roanoke, VA. BLUE RIDGE PHYSICAL MEDICINE NPI is 1710173679. The provider is registered as an organization entity type.

The provider's business location address is:

4582 FRANKLIN RD SW
ROANOKE, VA
ZIP 24014-144
Phone: (540) 772-8052
Fax: (540) 772-4508

The provider's authorized official is Rebecca W Tanner .
The authorized official title is Owner and has the following contact phone number (540) 772-8052.

The enumeration date for this NPI number is 9/24/2007 and was last updated on 9/24/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP3300X	Clinic/Center	Pain			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	6801510	MEDICAID	VIRGINIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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