Provider Demographics
NPI:1851336291
Name:BLUE RIDGE RADIATION ONCOLOGY
Entity Type:Organization
Organization Name:BLUE RIDGE RADIATION ONCOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:L
Authorized Official - Last Name:STRAUS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:540-722-8912
Mailing Address - Street 1:2809 EMERYWOOD PKWY
Mailing Address - Street 2:STE 210
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23294
Mailing Address - Country:US
Mailing Address - Phone:804-756-5130
Mailing Address - Fax:804-672-6899
Practice Address - Street 1:1870 AMHERST ST
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22602
Practice Address - Country:US
Practice Address - Phone:540-722-8912
Practice Address - Fax:540-722-2635
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-19
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC02475Medicare ID - Type Unspecified
CF1946Medicare PIN