Provider Demographics
NPI:1528397585
Name:BLUE RIDGE PREMIER MEDICINE, PLLC
Entity Type:Organization
Organization Name:BLUE RIDGE PREMIER MEDICINE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:J
Authorized Official - Last Name:CUMMINGS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:828-277-6789
Mailing Address - Street 1:70 PEACHTREE ROAD, SUITE 230
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803
Mailing Address - Country:US
Mailing Address - Phone:828-277-6789
Mailing Address - Fax:828-277-6780
Practice Address - Street 1:70 PEACHTREE ROAD, SUITE 230
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803
Practice Address - Country:US
Practice Address - Phone:828-277-6789
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-21
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty