OrganizationBlue Ridge Medical Management Corp(<Unavail>)Family MedicineAllopathic & Osteopathic PhysiciansPractice Address1905 American Way, Kingsport, TN 37660-5882(423) 578-8451(423) 952-2111PECOS EnrollmentBased on the most recent information from CMS, provider Blue Ridge Medical Management Corp does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1528723251Provider TypeOrganizationFull NameBlue Ridge Medical Management CorpOther Name<Unavail>SubpartNoEnumeration Date11/8/2021Last Updated10/1/2024Contact InformationPractice LocationPractice Address1905 American Way, Kingsport, TN 37660-5882Phone(423) 578-8451Fax(423) 230-8224Mailing LocationMailing Address1021 W Oakland Ave Ste 310, Johnson City, TN 37604-2192Phone(423) 952-2111Fax(423) 282-1657Authorized OfficialNameKilgore, Carl (Executive)Phone(423) 302-3051Provider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicenseUnlisted Issuer