| Blue Ridge Internal Medicine Inc. | |
|
407 12th Street Ext Princeton WV 24740-2300 | |
| (304) 487-0232 | |
| (304) 487-0285 |
| Full Name | Blue Ridge Internal Medicine Inc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 407 12th Street Ext, Princeton, West Virginia |
| Authorized Official Name and Position | Todd Andrew Smith (PRESIDENT) |
| Authorized Official Contact | 3044870232 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Ridge Internal Medicine Inc. Po Box 5065 Princeton WV 24740-5065 Ph: (304) 487-0232 | Blue Ridge Internal Medicine Inc. 407 12th Street Ext Princeton WV 24740-2300 Ph: (304) 487-0232 |
| NPI Number | 1285729178 |
|---|---|
| Provider Enumeration Date | 10/04/2006 |
| Last Update Date | 07/10/2008 |
| Medicare PECOS PAC ID | 4284675463 |
|---|---|
| Medicare Enrollment ID | O20050518000396 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285729178 | NPI | - | NPPES |
| 3810003706 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 1804 (West Virginia) | Primary |
| Provider Name | Michael B Remines |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205891942 PECOS PAC ID: 2860433950 Enrollment ID: I20050519000007 |
| Provider Name | Christopher D Parrish |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801042239 PECOS PAC ID: 7618017054 Enrollment ID: I20091216000415 |
| Provider Name | Todd A Smith |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780649889 PECOS PAC ID: 8527009703 Enrollment ID: I20100308000876 |
| Provider Name | Jessica Sheets |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659618098 PECOS PAC ID: 2860647872 Enrollment ID: I20130223000054 |
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