Provider Demographics
NPI:1164114914
Name:BLUE RIDGE SCIENTIFIC TRANSPORT LLC
Entity Type:Organization
Organization Name:BLUE RIDGE SCIENTIFIC TRANSPORT LLC
Other - Org Name:BLUE RIDGE SCIENTIFIC
Other - Org Type:Other Name
Authorized Official - Title/Position:VP OCCUPATIONAL HEALTH SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GORDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-784-9305
Mailing Address - Street 1:21556 TIMBERLAKE RD STE D
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24502-7226
Mailing Address - Country:US
Mailing Address - Phone:877-784-9305
Mailing Address - Fax:
Practice Address - Street 1:21556 TIMBERLAKE RD STE D
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24502-7226
Practice Address - Country:US
Practice Address - Phone:877-784-9305
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-22
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine