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NPI Code Detail

MEDICARE: RURAL HEALTH CARE INCORPORATED

MEDICARE: RURAL HEALTH CARE INCORPORATED
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician
2261QC1500XCommunity Health Clinic/CenterL800009980FL
3261QF0400XFederally Qualified Health Center (FQHC)

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3DE2912OTHERFLMEDICARE RAILROAD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1073589065
Entity Type Code : Organization
Provider Name (Legal Business Name) : RURAL HEALTH CARE INCORPORATED
Provider Business Mailing Address
First Line : 1302 RIVER ST
Second Line :
City : PALATKA
State : FL
Zip : 32177-5042
Country : US
Telephone Number : 386-328-0108
Fax Number : 386-325-1086
Provider Business Practice Location Address
First Line : 100 COMMERCIAL DR
Second Line :
City : KEYSTONE HEIGHTS
State : FL
Zip : 32656-6802
Country : US
Telephone Number : 352-473-6595
Fax Number : 352-473-6597
Authorized Official
Title or Position : CHIEF EXECUTIVE OFFICER
Name : LAURA M. SPENCER
Credential :
Telephone Number : 386-328-0108
Provider Enumeration Date : 02/28/2006
Last Update Date : 02/13/2020

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1629043856 — MICHAEL J VERNACCHIO DO
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1306928197 — RURAL HEALTH CARE, INC.
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Directions to “RURAL HEALTH CARE INCORPORATED ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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