Blue Ridge Optical
Organization Active NPI Optician · Hardy, VA
NPI 1508898057 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1508898057
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optician 156FX1800X
- License
- 1101 001548 (VA)
- Legal business name
- BLUE RIDGE OPTICAL
- Practice address
- 13295 Booker T Washington Hwy
Hardy, VA 24101-3947 - Phone
- (540) 721-7200
- NPI assigned
- Jul 7, 2006
- Organization subpart
- No
Authorized official
- Name
- Kristen Jana Calhoun
- Title
- Lic. Optician
- Phone
- (540) 721-7200
Subparts reporting this organization as parent 4
Corporate family (same tax ID) 3
National Provider Directory
- Tax ID family
- Blue Ridge Optical
Locations
13295 Booker T Washington Hwy
Hardy, VA 24101
Phone (540) 721-4433
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician |
156FX1800X | 1101 001548 | VA | Yes |
Addresses
Primary practice location
13295 Booker T Washington Hwy
Hardy, VA 24101-3947
Mailing address
13295 Booker T Washington Hwy
Hardy, VA 24101-3947
Phone (540) 721-7200
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9280561 | Medicaid | VA |
Other providers in Hardy, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.