BLUE RIDGE OPTICAL NPI 1639192594

NPI Information

  • NPI: 1639192594
  • Provider Name: BLUE RIDGE OPTICAL
  • Classification: Eyewear Supplier - 332H00000X
  • Entity Type: Organization
  • Address: 1960 ELECTRIC RD
    ROANOKE, VA
    ZIP 24018
  • Phone: (540) 776-9722

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NPI Details

BLUE RIDGE OPTICAL is an eyewear supplier in Roanoke, VA. The provider is an organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. BLUE RIDGE OPTICAL NPI is 1639192594. The provider is registered as an organization entity type.

The provider's business location address is:

1960 ELECTRIC RD
ROANOKE, VA
ZIP 24018-621
Phone: (540) 776-9722
Fax: (504) 776-5119

The provider's authorized official is Christopher M Clark .
The authorized official title is Manager and has the following contact phone number (540) 776-9722.

The enumeration date for this NPI number is 7/25/2006 and was last updated on 6/15/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1332H00000XEyewear SupplierVIRGINIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
192-8062-6MEDICAIDVIRGINIA
21027270001MEDICARE NSCVIRGINIA
3452898OTHERVIRGINIAANTHEM

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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