Provider Demographics
NPI:1467634410
Name:ROCK CASTLE NURSING & NUTRITION SERVICES
Entity Type:Organization
Organization Name:ROCK CASTLE NURSING & NUTRITION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:BARNETTE
Authorized Official - Last Name:WATKINS
Authorized Official - Suffix:
Authorized Official - Credentials:MA,RD,RN,CDE
Authorized Official - Phone:803-699-7369
Mailing Address - Street 1:700 RIDGE TRAIL DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29229-9061
Mailing Address - Country:US
Mailing Address - Phone:803-699-7369
Mailing Address - Fax:803-788-7335
Practice Address - Street 1:700 RIDGE TRAIL DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29229-9061
Practice Address - Country:US
Practice Address - Phone:803-699-7369
Practice Address - Fax:803-788-7335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-02
Last Update Date:2007-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC68138251B00000X, 251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251K00000XAgenciesPublic Health or Welfare