Organization
BLUE RIDGE OPTICAL
Active
Parent organization
BLUE RIDGE OPTICAL
Organization subpart
Yes
Provider details
NPI number
Legal business name
BLUE RIDGE OPTICAL
Authorized official
MR. CHRISTOPHER CLARK (MANAGER/LICENSED OPTICIAN)
(540) 776-9722
Entity
Organization
Contact information
Practice address
33 BRITISH WOODS DR, 1960 ELECTRIC ROAD, ROANOKE, VA 24019-8267
(540) 992-6797
Mailing address
33 BRITISH WOODS DR, 1960 ELECTRIC ROAD, ROANOKE, VA 24019-8267
(540) 992-6797
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
1101 000964
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OP2378
EYEMED VISION CARE
VA
Enumeration date
05/12/2008
Last updated
06/15/2015
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