Provider Demographics
NPI:1518311174
Name:HOSPICE OF RUTHERFORD COUNTY, INC.
Entity Type:Organization
Organization Name:HOSPICE OF RUTHERFORD COUNTY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:RITA
Authorized Official - Middle Name:
Authorized Official - Last Name:BURCH
Authorized Official - Suffix:
Authorized Official - Credentials:BSW, MBA
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:
Practice Address - Street 1:130 FOREST GLEN RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:NC
Practice Address - Zip Code:28722-3456
Practice Address - Country:US
Practice Address - Phone:828-894-7000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-20
Last Update Date:2016-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHOS0396251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3401557Medicaid
NC2332716OtherMEDICARE PART B
NC2332716OtherMEDICARE PART B