Provider Demographics
NPI:1770640575
Name:BLUE RIDGE HEALTHCARE HOSPITALS, INC.
Entity Type:Organization
Organization Name:BLUE RIDGE HEALTHCARE HOSPITALS, INC.
Other - Org Name:CMC BLUE RIDGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:FRITTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-580-5545
Mailing Address - Street 1:2201 S STERLING ST
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28655-4044
Mailing Address - Country:US
Mailing Address - Phone:828-580-5000
Mailing Address - Fax:828-580-5039
Practice Address - Street 1:2201 S STERLING ST
Practice Address - Street 2:
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-4044
Practice Address - Country:US
Practice Address - Phone:828-580-5000
Practice Address - Fax:828-580-5039
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2013-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCH0062273R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3400075SMedicaid