Provider Demographics
NPI:1366596975
Name:RUTHERFORD COUNTY DSS
Entity type:Organization
Organization Name:RUTHERFORD COUNTY DSS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:K
Authorized Official - Last Name:CARROLL
Authorized Official - Suffix:
Authorized Official - Credentials:MHDL
Authorized Official - Phone:828-287-6171
Mailing Address - Street 1:389 FAIRGROUND RD
Mailing Address - Street 2:
Mailing Address - City:SPINDALE
Mailing Address - State:NC
Mailing Address - Zip Code:28160-2204
Mailing Address - Country:US
Mailing Address - Phone:828-287-6168
Mailing Address - Fax:828-287-6350
Practice Address - Street 1:389 FAIRGROUND RD
Practice Address - Street 2:
Practice Address - City:SPINDALE
Practice Address - State:NC
Practice Address - Zip Code:28160-2204
Practice Address - Country:US
Practice Address - Phone:828-287-6168
Practice Address - Fax:828-287-6350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8700034Medicaid