Provider Demographics
NPI:1093811598
Name:BLUE RIDGE WOMEN'S HEALTH CENTER
Entity Type:Organization
Organization Name:BLUE RIDGE WOMEN'S HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:EN
Authorized Official - Last Name:SEDWICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-433-6613
Mailing Address - Street 1:1885 PORT REPUBLIC RD
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-3533
Mailing Address - Country:US
Mailing Address - Phone:540-433-6613
Mailing Address - Fax:540-433-6605
Practice Address - Street 1:1885 PORT REPUBLIC RD
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-3533
Practice Address - Country:US
Practice Address - Phone:540-433-6613
Practice Address - Fax:540-433-6605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2017-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101029047174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006202471Medicaid
VA007788541Medicaid
VA007788541Medicaid
VA500000729Medicare ID - Type Unspecified
VAP27727Medicare UPIN
VAB09625Medicare UPIN