Provider Demographics
NPI:1720757248
Name:BLUE RIDGE INDEPENDENCE AT HOME
Entity type:Organization
Organization Name:BLUE RIDGE INDEPENDENCE AT HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:RINGER
Authorized Official - Suffix:
Authorized Official - Credentials:CFO
Authorized Official - Phone:540-313-9200
Mailing Address - Street 1:333 W CORK ST UNIT 405
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-3876
Mailing Address - Country:US
Mailing Address - Phone:540-313-9200
Mailing Address - Fax:540-678-0772
Practice Address - Street 1:333 W CORK ST UNIT 405
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-3876
Practice Address - Country:US
Practice Address - Phone:540-313-9200
Practice Address - Fax:540-678-0772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-08
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization