Healthcare Provider Details

I. General information

NPI: 1932263332
Provider Name (Legal Business Name): RURAL HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2006
Last Update Date: 09/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

803 N 1ST ST
VIENNA IL
62995
US

IV. Provider business mailing address

513 N MAIN ST
ANNA IL
62906-1668
US

V. Phone/Fax

Practice location:
  • Phone: 618-658-2811
  • Fax: 618-658-2439
Mailing address:
  • Phone: 618-833-4471
  • Fax: 618-833-8878

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: MS. CYNTHIA K FLAMM
Title or Position: CEO
Credential: LCSW
Phone: 618-833-4471