Healthcare Provider Details

I. General information

NPI: 1053852525
Provider Name (Legal Business Name): RURAL HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2017
Last Update Date: 04/10/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 CLYBURN PLACE
AIKEN SC
29801-4193
US

IV. Provider business mailing address

1000 CLYBURN PLACE
AIKEN SC
29801-4193
US

V. Phone/Fax

Practice location:
  • Phone: 803-380-7000
  • Fax: 803-502-8491
Mailing address:
  • Phone: 803-380-7000
  • Fax: 803-502-4248

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number StateSC
# 3
Primary TaxonomyN
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DONALD BRANUM
Title or Position: CEO
Credential:
Phone: 803-380-7000