National Provider Identifier Database

BLUE RIDGE OPTICAL
Eyewear Supplier

An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.


Contact Information

BLUE RIDGE OPTICAL
1960 ELECTRIC RD
ROANOKE, VA24018-1621
Phone: 540-776-9722
Fax: 504-776-5119
Website:
Specialty Taxonomy Code
* Eyewear Supplier 332H00000X

* Indicates primary specialty

NPI Profile & details for BLUE RIDGE OPTICAL

NPI Number 1639192594
Legal business name
LBN
BLUE RIDGE OPTICAL
Authorized official CHRISTOPHER CLARK - (MANAGER)
Entity Organization
Organization subpart Yes
Enumeration date 07/25/2006
Last updated 06/15/2015 - About 11 years ago
Sole proprietor1 Not specified
Identifiers
  • VA Medicaid: 92-8062-6
  • VA Other: 452898 ANTHEM

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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