Provider Demographics
NPI:1063674166
Name:HOSPICE OF RUTHERFORD COUNTY, INC
Entity Type:Organization
Organization Name:HOSPICE OF RUTHERFORD COUNTY, INC
Other - Org Name:HOSPICE OF THE CAROLINA FOOTHILLS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RITA
Authorized Official - Middle Name:R
Authorized Official - Last Name:BURCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-245-0095
Mailing Address - Street 1:PO BOX 336
Mailing Address - Street 2:
Mailing Address - City:FOREST CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28043-0336
Mailing Address - Country:US
Mailing Address - Phone:828-245-0095
Mailing Address - Fax:828-245-5389
Practice Address - Street 1:260 FAIRWINDS RD.
Practice Address - Street 2:
Practice Address - City:LANDRUM
Practice Address - State:SC
Practice Address - Zip Code:29356-9075
Practice Address - Country:US
Practice Address - Phone:864-457-9100
Practice Address - Fax:864-457-9120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-30
Last Update Date:2016-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCHPC 035251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCHPC-035OtherSC DHEC
SCHSP162Medicaid
SCHSP100Medicaid
SC421587Medicare PIN