Organization Name: | BLUE RIDGE MEDICAL MANAGEMENT CORPORATION |
NPI Number: | 1073748539 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CARL STEVEN KILGORE (PRESIDENT) |
Mailing Address: | 1503 W Elk Ave Suite 8 Elizabethton |
State: | TN US |
Postal Code: | 376432876 |
Phone Number: | 4235438619 |
Fax Number: | 4235435133 |
NPI Enumeration Date: | 05/27/2009 |
NPI Last Update Date: | 10/26/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |