Organization
BLUE RIDGE HEALTHCARE MEDICAL GROUP INC
Active
Other names
Blue Ridge Long Term Care Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT G FRITTS (SVP/CFO)
(828) 580-5000
Entity
Organization
Contact information
Practice address
2201 S STERLING ST, MORGANTON, NC 28655-4044
(828) 580-5000
Mailing address
103 MEDICAL HEIGHTS DR, MORGANTON, NC 28655-5197
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
28077
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2327875
MEDICARE PTAN
NC
01
—
5921614
COLLEGE PINES MEDICAID
NC
01
—
5921615
GRACE HEIGHTS MEDICAID
NC
01
—
5921616
GRACE RIDGE MEDICAID
NC
Enumeration date
09/27/2012
Last updated
06/19/2013
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