Provider Demographics
NPI:1720556269
Name:MH BLUE RIDGE MEDICAL CENTER, LLLP
Entity Type:Organization
Organization Name:MH BLUE RIDGE MEDICAL CENTER, LLLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:D
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:615-344-6215
Mailing Address - Street 1:189 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:SPRUCE PINE
Mailing Address - State:NC
Mailing Address - Zip Code:28777-3035
Mailing Address - Country:US
Mailing Address - Phone:828-213-4444
Mailing Address - Fax:
Practice Address - Street 1:189 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:SPRUCE PINE
Practice Address - State:NC
Practice Address - Zip Code:28777-3035
Practice Address - Country:US
Practice Address - Phone:828-213-4444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MH BLUE RIDGE MEDICAL CENTER, LLLP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-11-02
Last Update Date:2019-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural HealthGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty