MEDICARE: RURAL HEALTH SOLUTIONS PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2300X	Primary Care Clinic/Center
2	261QR1300X	Rural Health Clinic/Center	J2176	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417998287
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RURAL HEALTH SOLUTIONS PA

Provider Business Mailing Address
First Line	:	PO BOX 10426
Second Line	:
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78460-0426
Country	:	US
Telephone Number	:	361-387-9233
Fax Number	:	361-387-8992

Provider Business Practice Location Address
First Line	:	327 W AVE J
Second Line	:
City	:	ROBSTOWN
State	:	TX
Zip	:	78380-2207
Country	:	US
Telephone Number	:	361-387-9233
Fax Number	:	361-387-8992

Authorized Official
Title or Position	:	PHYSICIAN OWNER
Name	:	DR. ELLIS G MAIN
Credential	:	DO
Telephone Number	:	361-387-9233

Provider Enumeration Date	:	06/10/2006
Last Update Date	:	08/15/2022

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Practice Location Address:

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Directions to “RURAL HEALTH SOLUTIONS PA ” Practice Location

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