Organization
COMMUNITY CARE OF RUTHERFORD COUNTY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK KING (ADMINISTRATOR)
(615) 893-2624
Entity
Organization
Contact information
Practice address
901EAST COUNTY FARM RD, MURFREESBORO, TN 37127-6328
(615) 893-2624
(615) 898-7989
Mailing address
901 EAST COUNTY FARM RD, MURFREESBORO, TN 37127-6328
(615) 893-2624
(615) 898-7989
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0000000219
TN
332BN1400X
Nursing Facility Supplies (DME)
—
TN
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
TN
Other
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
Enumeration date
07/28/2005
Last updated
11/26/2008
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