# BLUE RIDGE MEDICAL MANAGEMENT C ORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Ballad Health Medical Associates
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508592189
- **Authorized official:** PATRICIA TARTE (ENROLLMENT)
- **Authorized official phone:** (423) 302-6565

## Contact information

- **Practice address:** 2030 TEMPLE HILL RD, ERWIN, TN 37650-8721
- **Practice address phone:** (423) 230-8367
- **Practice address fax:** (423) 610-3430
- **Mailing address:** 509 MED TECH PKWY STE 100, JOHNSON CITY, TN 37604-2579
- **Mailing address phone:** (423) 302-6565

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RP1001X | Pulmonary Disease Physician | — | NULL | Yes |
| 207RP1001X | Pulmonary Disease Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/27/2022
- **Last updated:** 07/27/2022