Organization
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION
Active
Other names
First Assist Urgent Care
Organization subpart
No
Provider details
NPI number
Authorized official
CARL STEVEN KILGORE (PRESIDENT)
(423) 915-5185
Entity
Organization
Contact information
Practice address
1019 W OAKLAND AVE, SUITE 1, JOHNSON CITY, TN 37604-2357
(423) 915-5000
(423) 915-5045
Mailing address
1019 W OAKLAND AVE, SUITE 1, JOHNSON CITY, TN 37604-2357
(423) 915-5000
(423) 915-5045
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
165510201
DEPARTMENT OF LABOR
TN
05
—
3706267
—
TN
01
—
CA5744
RAILROAD MEDICARE
TN
Enumeration date
06/27/2006
Last updated
02/14/2017
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