NPIMap

Organization Active NPI

Blue Ridge Healthcare Hospitals Inc

Doing business as Blue Ridge Long Term Care Pharmacy

  • Community/Retail Pharmacy
  • Valdese, NC
National Provider Identifier
1184760795
Registry record updated Dec 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
08253 Issued in NC
Legal business name
BLUE RIDGE HEALTHCARE HOSPITALS INC
Doing business as
Blue Ridge Long Term Care Pharmacy
Practice address
298 Perkins Rd SE
Valdese, NC 28690-9403
Phone
(828) 580-5464
Fax
(828) 874-2679
NPI assigned
Jan 30, 2007
Last updated
Dec 31, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ron Fulmer, BS
Title
Pharmacy Manager
Phone
(828) 580-5464

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 08253 NC Primary
Long Term Care Pharmacy 3336L0003X NU

Addresses

Primary practice location

298 Perkins Rd SE
Valdese, NC 28690-9403

Mailing address

298 Perkins Rd SE
Valdese, NC 28690-9403
Phone (828) 580-5464

Other identifiers 2

IdentifierTypeStateIssuer
2067509OtherPK
0125070MedicaidNC

Other names 1

  • BLUE RIDGE LONG TERM CARE PHARMACY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Mountain View Pediatric9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

298 Perkins Rd SE
Valdese, NC 28690
Phone (828) 580-5460

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1451520000000",
    "number": "1184760795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "298 PERKINS RD SE",
            "city": "VALDESE",
            "state": "NC",
            "postal_code": "286909403",
            "telephone_number": "828-580-5464",
            "fax_number": "828-874-2679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "298 PERKINS RD SE",
            "city": "VALDESE",
            "state": "NC",
            "postal_code": "286909403",
            "telephone_number": "828-580-5464",
            "fax_number": "828-874-2679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE RIDGE HEALTHCARE HOSPITALS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2015-12-31",
        "status": "A",
        "authorized_official_last_name": "FULMER",
        "authorized_official_first_name": "RON",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "828-580-5464",
        "authorized_official_credential": "BS"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NC",
            "license": "08253",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2067509",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0125070",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BLUE RIDGE LONG TERM CARE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Valdese, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.