Provider Demographics
NPI:1023084399
Name:HOSPICE & PALLIATIVE CARE OF THE BLUE RIDGE INC
Entity type:Organization
Organization Name:HOSPICE & PALLIATIVE CARE OF THE BLUE RIDGE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:MEADOWS
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-765-5677
Mailing Address - Street 1:236 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:SPRUCE PINE
Mailing Address - State:NC
Mailing Address - Zip Code:28777-8944
Mailing Address - Country:US
Mailing Address - Phone:828-765-5677
Mailing Address - Fax:828-765-5680
Practice Address - Street 1:236 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:SPRUCE PINE
Practice Address - State:NC
Practice Address - Zip Code:28777-8944
Practice Address - Country:US
Practice Address - Phone:828-765-5677
Practice Address - Fax:828-765-5680
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-27
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251G00000X, 251J00000X, 253Z00000X, 385H00000X
NCHOS0832302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization
No251G00000XAgenciesHospice Care, Community Based
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3401565Medicaid
NC341565Medicare Oscar/Certification