Provider Demographics
NPI:1144400094
Name:RUTHERFORD HOSPITAL, INC.
Entity Type:Organization
Organization Name:RUTHERFORD HOSPITAL, INC.
Other - Org Name:CARDIOLOGY SERVICES OF RUTHERFORD HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP/CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:B
Authorized Official - Last Name:BROSS
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:828-286-5000
Mailing Address - Street 1:288 S RIDGECREST AVE
Mailing Address - Street 2:
Mailing Address - City:RUTHERFORDTON
Mailing Address - State:NC
Mailing Address - Zip Code:28139-2838
Mailing Address - Country:US
Mailing Address - Phone:828-286-7285
Mailing Address - Fax:828-286-7287
Practice Address - Street 1:288 S RIDGECREST AVE
Practice Address - Street 2:
Practice Address - City:RUTHERFORDTON
Practice Address - State:NC
Practice Address - Zip Code:28139-2838
Practice Address - Country:US
Practice Address - Phone:828-286-7285
Practice Address - Fax:828-286-7287
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-08
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC019TTOtherBCBS
NC5908647Medicaid
NC5908647Medicaid