| Blue Ridge Medical Management Corporation | |
|
71 S Flannagan Ave Lebanon VA 24266 | |
| (276) 883-8042 | |
| (276) 883-8044 |
| Full Name | Blue Ridge Medical Management Corporation |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 71 S Flannagan Ave, Lebanon, Virginia |
| Authorized Official Name and Position | Carl Steven Kilgore (PRESIDENT) |
| Authorized Official Contact | 4233023051 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Ridge Medical Management Corporation 71 S Flannagan Ave Lebanon VA 24266 Ph: (276) 883-8042 | Blue Ridge Medical Management Corporation 71 S Flannagan Ave Lebanon VA 24266 Ph: (276) 883-8042 |
| NPI Number | 1275701559 |
|---|---|
| Provider Enumeration Date | 02/20/2008 |
| Last Update Date | 04/21/2025 |
| Certification Date | 04/21/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275701559 | NPI | - | NPPES |
| 622377500 | Other | VA | DEPARTMENT OF LABOR |
| 600952284 | Other | VA | MAGELLAN |
| DF7910 | Other | VA | RAILROAD MEDICARE |
| 1275701559 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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