MEDICARE: RURAL HEALTH GROUP, INC.

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
1	261QF0400X	Federally Qualified Health Center (FQHC)		NC

General Provider Information

NPI Number	:	1669500997
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RURAL HEALTH GROUP, INC.

Provider Business Mailing Address
First Line	:	PO BOX 640
Second Line	:
City	:	ROANOKE RAPIDS
State	:	NC
Zip	:	27870-0640
Country	:	US
Telephone Number	:	252-536-5440
Fax Number	:	252-536-5444

Provider Business Practice Location Address
First Line	:	2064 NC HIGHWAY 125
Second Line	:
City	:	ROANOKE RAPIDS
State	:	NC
Zip	:	27870-9436
Country	:	US
Telephone Number	:	252-536-5880
Fax Number	:	252-536-2708

Authorized Official
Title or Position	:	CEO
Name	:	YVONNE LONG-GEE
Credential	:
Telephone Number	:	252-536-5789

Provider Enumeration Date	:	02/28/2007
Last Update Date	:	06/12/2023

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