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General NPI Number Information
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NPI Number | 1962763045
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Entity Type | Organization
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Legal Business Name | RURAL HEALTH, INC.
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Dates
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Enumeration Date | 06/05/2012
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Last Update Date | 04/25/2016
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Provider Practice Location Address
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Address Line | 400 S BROADWAY
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City | GOREVILLE
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State | IL
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Zip | 62939-2444
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Country | US
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Telephone | 618-995-1002
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Fax | 618-995-1133
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Provider Business Mailing Address
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Address Line | 513 N MAIN ST
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City | ANNA
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State | IL
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Zip | 62906-1668
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Country | US
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Telephone | 618-833-4471
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Fax | 618-833-8878
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MS. CYNTHIA K FLAMM
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Credential | MSW, LCSW
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Telephone | 618-833-4471
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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