Provider Demographics
NPI:1578034054
Name:MH BLUE RIDGE MEDICAL CENTER, LLLP
Entity Type:Organization
Organization Name:MH BLUE RIDGE MEDICAL CENTER, LLLP
Other - Org Name:MISSION COMMUNITY PHARMACY - SPRUCE PINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TONIA
Authorized Official - Middle Name:WYNNE
Authorized Official - Last Name:HALE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-766-1801
Mailing Address - Street 1:189 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:SPRUCE PINE
Mailing Address - State:NC
Mailing Address - Zip Code:28777-3035
Mailing Address - Country:US
Mailing Address - Phone:828-766-2950
Mailing Address - Fax:
Practice Address - Street 1:189 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:SPRUCE PINE
Practice Address - State:NC
Practice Address - Zip Code:28777-3035
Practice Address - Country:US
Practice Address - Phone:828-766-2950
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MH BLUE RIDGE MEDICAL CENTER, LLLP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-12-10
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy