# COMMUNITY CARE OF RUTHERFORD COUNTY, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508866898
- **Authorized official:** MARK KING (ADMINISTRATOR)
- **Authorized official phone:** (615) 893-2624

## Contact information

- **Practice address:** 901EAST COUNTY FARM RD, MURFREESBORO, TN 37127-6328
- **Practice address phone:** (615) 893-2624
- **Practice address fax:** (615) 898-7989
- **Mailing address:** 901 EAST COUNTY FARM RD, MURFREESBORO, TN 37127-6328
- **Mailing address phone:** (615) 893-2624
- **Mailing address fax:** (615) 898-7989

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 0000000219 | TN | Yes |
| 332BN1400X | Nursing Facility Supplies (DME) | — | TN | — |
| 332BP3500X | Parenteral & Enteral Nutrition Supplies (DME) | — | TN | — |

## Other

- **Enumeration date:** 07/28/2005
- **Last updated:** 11/26/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0445406 | — | TN |
| 01 | — | 3110468 | BLUE CROSS BLUE SHIELD | TN |
| 01 | — | 4100484 | BLUECROSS ALLIED PROVIDER | TN |
| 05 | — | 7440175 | — | TN |