Healthcare Provider Details

I. General information

NPI: 1720281116
Provider Name (Legal Business Name): RURAL HEALTH CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2007
Last Update Date: 02/20/2020
Certification Date: 02/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1302 RIVER ST
PALATKA FL
32177-5042
US

IV. Provider business mailing address

1302 RIVER ST
PALATKA FL
32177-5042
US

V. Phone/Fax

Practice location:
  • Phone: 386-328-0558
  • Fax: 386-328-9443
Mailing address:
  • Phone: 386-328-0108
  • Fax: 386-325-1086

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPH0009296
License Number StateFL

VIII. Authorized Official

Name: LAURA M SPENCER
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 386-328-0108