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General NPI Number Information
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NPI Number | 1720849540
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Entity Type | Organization
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Legal Business Name | NORTH FLORIDA RURAL HEALTH CORP
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Dates
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Enumeration Date | 01/18/2024
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Last Update Date | 01/18/2024
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Provider Practice Location Address
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Address Line | 680 MAPLE ST STE 100
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City | CHATTAHOOCHEE
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State | FL
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Zip | 32324-1826
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Country | US
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Telephone | 850-759-9223
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Fax |
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Provider Business Mailing Address
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Address Line | 600 34TH ST S
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City | ST PETERSBURG
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State | FL
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Zip | 33711-1722
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | WALTER KYLES
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Credential |
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Telephone | 850-999-3181
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336M0002X
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Taxonomy Name | Mail Order Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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