Provider Demographics
NPI:1871510834
Name:BLUE RIDGE RADIOLOGISTS INC.
Entity Type:Organization
Organization Name:BLUE RIDGE RADIOLOGISTS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:C
Authorized Official - Last Name:LEACH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-886-0988
Mailing Address - Street 1:401 COMMERCE RD
Mailing Address - Street 2:SUITE 413
Mailing Address - City:STAUNTON
Mailing Address - State:VA
Mailing Address - Zip Code:24401-4446
Mailing Address - Country:US
Mailing Address - Phone:540-886-0988
Mailing Address - Fax:540-886-3833
Practice Address - Street 1:401 COMMERCE RD
Practice Address - Street 2:SUITE 413
Practice Address - City:STAUNTON
Practice Address - State:VA
Practice Address - Zip Code:24401-4446
Practice Address - Country:US
Practice Address - Phone:540-886-0988
Practice Address - Fax:540-886-3833
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty