Provider Demographics
NPI:1467561498
Name:DLP RUTHERFORD REGIONAL HEALTH SYSTEM, LLC
Entity Type:Organization
Organization Name:DLP RUTHERFORD REGIONAL HEALTH SYSTEM, LLC
Other - Org Name:CAROLINA HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:E
Authorized Official - Last Name:GIOVANETTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-920-7000
Mailing Address - Street 1:330 SEVEN SPRINGS WAY
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-4536
Mailing Address - Country:US
Mailing Address - Phone:615-920-7000
Mailing Address - Fax:615-920-8913
Practice Address - Street 1:2270 US HIGHWAY 74A BYP
Practice Address - Street 2:SUITE 345
Practice Address - City:FOREST CITY
Practice Address - State:NC
Practice Address - Zip Code:28043-2434
Practice Address - Country:US
Practice Address - Phone:828-245-3575
Practice Address - Fax:828-245-5426
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2017-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC0186251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3408493Medicaid
0074JOtherBCBS
NC0465GOtherBCBS, DME
NC3407169Medicaid
NC6600123Medicaid
NC7700446Medicaid
NC6600123Medicaid