BLUE RIDGE OPTICAL; NPI #1639192594

Contact Information

BLUE RIDGE OPTICAL

1960 ELECTRIC RD
ROANOKE, VA 24018-1621

Phone: 540-776-9722
Fax: 504-776-5119
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Eyewear Supplier	332H00000X	87	All Other Suppliers

Indicates primary specialty

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NPI Profile & details for BLUE RIDGE OPTICAL

NPI Number 1639192594

LBN Legal business name BLUE RIDGE OPTICAL

Authorized official CHRISTOPHER CLARK - (MANAGER)

Entity Organization

Organization subpart ¹ Yes

Enumeration date 07/25/2006

Last updated 06/15/2015 - About 11 years ago

Identifiers

VA	Medicaid	92-8062-6
VA	Other	452898	ANTHEM

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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BLUE RIDGE OPTICAL

Contact Information

Specialty

Eyewear Supplier

NPI Profile & details for BLUE RIDGE OPTICAL

Reviews for BLUE RIDGE OPTICAL