Organization
BLUE RIDGE REGIONAL HOSPITAL, INC
Active
Other names
Mission Community Primary Care
Organization subpart
No
Provider details
NPI number
Authorized official
CLINT STEWART (REGIONAL DIRECTOR)
(828) 659-5196
Entity
Organization
Contact information
Practice address
11728 S 226 HWY, SPRUCE PINE, NC 28777-8954
(828) 765-5672
(828) 765-5676
Mailing address
PO BOX 602373, CHARLOTTE, NC 28260-2373
(828) 213-1500
(828) 651-6570
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
NC
207R00000X
Internal Medicine Physician
—
NC
208000000X
Pediatrics Physician
—
NC
261QR1300X
Rural Health Clinic/Center
Primary
—
—
363A00000X
Physician Assistant
—
NC
363L00000X
Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
018NU
BCBS NC
NC
05
—
343426
—
NC
Enumeration date
08/11/2006
Last updated
12/05/2016
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