Provider Demographics
NPI:1689770133
Name:CAROLINA CHIROPRACTIC PLUS OF RUTHERFORD COUNTY INC.
Entity Type:Organization
Organization Name:CAROLINA CHIROPRACTIC PLUS OF RUTHERFORD COUNTY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:R
Authorized Official - Last Name:MEMSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:828-245-0202
Mailing Address - Street 1:152 WEST MAIN ST.
Mailing Address - Street 2:
Mailing Address - City:FOREST CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28043
Mailing Address - Country:US
Mailing Address - Phone:828-245-0202
Mailing Address - Fax:828-245-0422
Practice Address - Street 1:152 WEST MAIN ST
Practice Address - Street 2:
Practice Address - City:FOREST CITY
Practice Address - State:NC
Practice Address - Zip Code:28043
Practice Address - Country:US
Practice Address - Phone:828-245-0202
Practice Address - Fax:828-245-0422
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0829XOtherBLUE CROSS BLUE SHIELD
NC890114EMedicaid
NC890829XMedicaid
NCU69047Medicare UPIN
NC890114EMedicaid
NC2333302Medicare UPIN