Organization
BLUE RIDGE INTERNAL MEDICINE INC.
Active
Parent organization
BLUE RIDGE INTERNAL MEDICINE INC.
Other names
Blue Ridge Internal Medicine Lab
Organization subpart
Yes
Provider details
NPI number
Legal business name
BLUE RIDGE INTERNAL MEDICINE INC.
Authorized official
MS. JACINDA SANTON SMITH (ADMINISTRATOR)
(304) 487-0232
Entity
Organization
Contact information
Practice address
407 12TH STREET EXT, PRINCETON, WV 24740-2300
(304) 487-0232
(304) 487-0285
Mailing address
PO BOX 5065, 407 12TH STREET EXTENSION, PRINCETON, WV 24740-5065
(304) 487-0232
(304) 487-0285
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
1804
WV
Other
Enumeration date
09/19/2007
Last updated
07/10/2008
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