Broc LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

BROC LLC

Doing business as

BLUE RIDGE NURSING CENTER

Practice address

300 Blue Ridge St
Martinsville, VA 24112-7261

Phone

(276) 638-8701

Fax

(276) 638-8843

NPI assigned

Mar 11, 2010

Organization subpart

No

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

Authorized official

Name

Mrs. Dorene M Ford

Title

Director of M.I.S.

Phone

(239) 963-3400

Specialties & licenses 1

Addresses

Other names 1

• BLUE RIDGE NURSING CENTER Doing business as

Locations

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

{
    "created_epoch": "1268265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525996800000",
    "number": "1770806291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 CENTREPARK BLVD STE 810",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334017412",
            "telephone_number": "239-963-3400",
            "fax_number": "239-963-3410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 BLUE RIDGE ST",
            "city": "MARTINSVILLE",
            "state": "VA",
            "postal_code": "241127261",
            "telephone_number": "276-638-8701",
            "fax_number": "276-638-8843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-11",
        "last_updated": "2018-05-11",
        "status": "A",
        "authorized_official_last_name": "FORD",
        "authorized_official_first_name": "DORENE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DIRECTOR OF M.I.S.",
        "authorized_official_telephone_number": "239-963-3400",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BLUE RIDGE NURSING CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BLUE RIDGE NURSING CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Martinsville, VA
• Providers in Martinsville, VA by specialty
• Skilled Nursing Facility in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2018; 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.