Organization
BLUE RIDGE NUTRITION SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANA W KARSCHNER (GENERAL COUNSEL)
(770) 939-8720
Entity
Organization
Contact information
Practice address
3538 HABERSHAM AT NORTHLAKE, TUCKER, GA 30084-4009
(770) 939-8720
(770) 938-7288
Mailing address
3538 HABERSHAM AT NORTHLAKE, TUCKER, GA 30084-4009
(770) 939-8720
(770) 938-7288
Taxonomy
Speciality
Code
Description
License number
State
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
Primary
106901
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000699311A
—
GA
Enumeration date
05/23/2007
Last updated
09/01/2009
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