Provider Demographics
NPI:1952485476
Name:TOE RIVER HEALTH DISTRICT
Entity Type:Organization
Organization Name:TOE RIVER HEALTH DISTRICT
Other - Org Name:AVERY COUNTY HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:HEALTH DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LYNDA
Authorized Official - Middle Name:
Authorized Official - Last Name:KINNANE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-765-9081
Mailing Address - Street 1:861 GREENWOOD RD
Mailing Address - Street 2:
Mailing Address - City:SPRUCE PINE
Mailing Address - State:NC
Mailing Address - Zip Code:28777-3113
Mailing Address - Country:US
Mailing Address - Phone:828-765-9081
Mailing Address - Fax:828-765-9082
Practice Address - Street 1:861 GREENWOOD RD
Practice Address - Street 2:
Practice Address - City:SPRUCE PINE
Practice Address - State:NC
Practice Address - Zip Code:28777-3113
Practice Address - Country:US
Practice Address - Phone:828-765-9081
Practice Address - Fax:828-765-9082
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2014-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC0317251E00000X
NCHC0319251E00000X
NCHC0323251E00000X
NC34D0882412291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3407100Medicaid
NC720273NMedicaid
NC00789OtherNC BLUE CROSS BLUE SHIELD
=========006OtherTRI CARE
=========005OtherTRI CARE
=========002OtherTRI CARE
=========OtherALL OTHER INSURANCES
NC3407100Medicaid
=========002OtherTRI CARE
=========004OtherTRI CARE
=========OtherALL OTHER INSURANCES
NC00789OtherNC BLUE CROSS BLUE SHIELD