Provider Demographics
NPI:1851442776
Name:BLUEMONT NEPHROLOGY ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:BLUEMONT NEPHROLOGY ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBBEE
Authorized Official - Middle Name:J
Authorized Official - Last Name:PINKARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-347-5696
Mailing Address - Street 1:406 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:WARRENTON
Mailing Address - State:VA
Mailing Address - Zip Code:20186-3026
Mailing Address - Country:US
Mailing Address - Phone:540-347-5696
Mailing Address - Fax:540-347-7152
Practice Address - Street 1:406 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:VA
Practice Address - Zip Code:20186-3026
Practice Address - Country:US
Practice Address - Phone:540-347-5696
Practice Address - Fax:540-347-7152
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2014-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC0172Medicare PIN