=====================================================
General NPI Number Information
=====================================================
NPI Number | 1770686743
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RUTHERFORD HOSPITAL, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/06/2006
-----------------------------------------------------
Last Update Date | 09/10/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 212 ALLENDALE DR
-----------------------------------------------------
City | FOREST CITY
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28043-2889
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 828-245-0191
-----------------------------------------------------
Fax | 828-245-8830
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 212 ALLENDALE DR
-----------------------------------------------------
City | FOREST CITY
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28043-2889
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 828-245-0191
-----------------------------------------------------
Fax | 828-245-8830
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MBA
-----------------------------------------------------
Name | MRS. MELODY T BRIDGES
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 828-286-5000
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QP2300X
-----------------------------------------------------
Taxonomy Name | Primary Care Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------