Provider Demographics
NPI:1376551044
Name:BLUE RIDGE E N T & P S INC.
Entity Type:Organization
Organization Name:BLUE RIDGE E N T & P S INC.
Other - Org Name:FEINMAN-CLARK ENT & PS, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:RAMEY
Authorized Official - Suffix:
Authorized Official - Credentials:CPS
Authorized Official - Phone:434-947-3993
Mailing Address - Street 1:2321 ATHERHOLT RD
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24501-2113
Mailing Address - Country:US
Mailing Address - Phone:434-947-3993
Mailing Address - Fax:434-947-3992
Practice Address - Street 1:2321 ATHERHOLT RD
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24501-2113
Practice Address - Country:US
Practice Address - Phone:434-947-3993
Practice Address - Fax:434-947-3992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-04
Last Update Date:2014-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC00549Medicare PIN