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NPI Code Detail

MEDICARE: RURAL HEALTH CARE, INC.

MEDICARE: RURAL HEALTH CARE, INC.
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
1333600000XPharmacyPH0016495FL
23336C0003XCommunity/Retail PharmacyPH0016495FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
31085960OTHEROTHER ID NUMBER-COMMERCIAL NUMBER

General Provider Information

NPI Number : 1689756470
Entity Type Code : Organization
Provider Name (Legal Business Name) : RURAL HEALTH CARE, INC.
Provider Business Mailing Address
First Line : PO BOX 817
Second Line :
City : PALATKA
State : FL
Zip : 32178-0817
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 306 UNION AVE
Second Line :
City : CRESCENT CITY
State : FL
Zip : 32112-4432
Country : US
Telephone Number : 386-698-2368
Fax Number : 386-698-4343
Authorized Official
Title or Position : VP/CPO
Name : LARRY WILLIAM PEDERSON
Credential : RPH, CPH
Telephone Number : 386-328-0558
Provider Enumeration Date : 10/20/2006
Last Update Date : 02/07/2020

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Directions to “RURAL HEALTH CARE, INC. ” Practice Location

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