Provider Demographics
NPI:1972876399
Name:HOSPICE OF RUTHERFORD COUNTY
Entity Type:Organization
Organization Name:HOSPICE OF RUTHERFORD COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RITA
Authorized Official - Middle Name:R
Authorized Official - Last Name:BURCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-245-0095
Mailing Address - Street 1:374 HUDLOW RD
Mailing Address - Street 2:
Mailing Address - City:FOREST CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28043-9444
Mailing Address - Country:US
Mailing Address - Phone:828-245-8471
Mailing Address - Fax:828-248-1378
Practice Address - Street 1:374 HUDLOW RD
Practice Address - Street 2:
Practice Address - City:FOREST CITY
Practice Address - State:NC
Practice Address - Zip Code:28043-9444
Practice Address - Country:US
Practice Address - Phone:828-245-8471
Practice Address - Fax:828-248-1378
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-15
Last Update Date:2012-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI9400625208D00000X
NC100690363LF0000X
NC138928363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty