Provider Demographics
NPI:1225508278
Name:BLUE RIDGE MEDICAL TRANSPORT
Entity Type:Organization
Organization Name:BLUE RIDGE MEDICAL TRANSPORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:RYAN
Authorized Official - Last Name:MCDARIS
Authorized Official - Suffix:
Authorized Official - Credentials:PRMDC
Authorized Official - Phone:706-633-8086
Mailing Address - Street 1:16658 MORGANTON HWY
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:GA
Mailing Address - Zip Code:30560-4144
Mailing Address - Country:US
Mailing Address - Phone:706-633-8086
Mailing Address - Fax:
Practice Address - Street 1:16658 MORGANTON HWY
Practice Address - Street 2:
Practice Address - City:MORGANTON
Practice Address - State:GA
Practice Address - Zip Code:30560-4144
Practice Address - Country:US
Practice Address - Phone:706-633-8086
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-03
Last Update Date:2019-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes341600000XTransportation ServicesAmbulanceGroup - Single Specialty
No3416L0300XTransportation ServicesAmbulanceLand Transport