RURAL HEALTH CARE INCORPORATED (NPI# 1114994944) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114994944 |
| Entity Type | Organization |
| Organization Name | RURAL HEALTH CARE INCORPORATED |
| Other Organization Name | AZA HEALTH |
| Practice Address |
22066 Se 71st Avenue Hawthorne FL 32640-3969 |
| Mailing Address |
1302 River St Palatka FL 32177-5042 |
| Practice Telephone | 3524812700 |
| Practice Fax Number | 3524812392 |
| Mailing Telephone | 3863280108 |
| Mailing Fax Number | 3863251086 |
| Enumeration Date | 2006-03-01 |
| Last Update Date | 2020-02-13 |
| Authorized Official Name | LAURA M. SPENCER (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 3863280108 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208D00000X | General Practice | Allopathic & Osteopathic Physicians | ||
| N | 261QC1500X |
Clinic/Center Specialization: Community Health |
L8000011321 | FL | Ambulatory Health Care Facilities |
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 029543406 | 05 | |
| FL | 036741806 | 05 | |
| FL | MEDICARE RAILROAD | CF6528 | 01 |
| Other Name | Type Code |
|---|---|
| Aza Health | Doing Business As Name - Organization |
| Azalea Health | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093211393 | Rural Health Care Incorporated | Pharmacy | 1425 Dunn Ave, Daytona Beach, FL 32114 | 2018-04-04 |
| 1700135522 | Rural Health Care Incorporated | Clinic/Center | 1305 N Orange Ave, Green Cove Springs, FL 32043-2553 | 2012-09-07 |
| 1164621744 | Rural Health Care Incorporated | General Practice | 405 Elm Street, Welaka, FL 32193 | 2007-07-13 |
| 1124236922 | Rural Health Care Incorporated | General Practice | 611 Zeagler Dr, Palatka, FL 32177-3810 | 2007-05-18 |
| 1235106618 | Rural Health Care Incorporated | Clinic/Center | 306 Union Ave, Crescent City, FL 32112-4432 | 2006-03-03 |
| 1477529311 | Rural Health Care Incorporated | Clinic/Center | 1213 State Road 20, Interlachen, FL 32148-2737 | 2006-02-28 |
| 1073589065 | Rural Health Care Incorporated | Family Medicine | 100 Commercial Dr, Keystone Heights, FL 32656-6802 | 2006-02-28 |
| 1871569061 | Rural Health Care Incorporated | Internal Medicine | 1302 River St, Palatka, FL 32177-5042 | 2006-02-27 |
| Street Address |
22066 SE 71ST AVENUE |
| City | HAWTHORNE |
| State | FL |
| Zip Code | 32640-3969 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174666341 | Christopher Robert Warren | Pharmacist | 22066 Se 71st Avenue, Azalea Health Hawthorne Phs, Hawthorne, FL 32640-3926 | 2007-02-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306303169 | Althea Pontoon | In Home Supportive Care | 144 Prairie Drive, Hawthorne, FL 32640 | 2019-02-27 |
| 1013446475 | Divine Care Services LLC | Home Health Aide | 21212 Se 62nd Ave, Hawthorne, FL 32640 | 2017-06-08 |
| 1073968715 | Crista Marina Ana Lucia Rosborough | Specialist | 21403 Se 70th Ave, Hawthorne, FL 32640 | 2016-05-02 |
| 1952781387 | Neil Franklin Letts | Ophthalmology | 160 Little Orange Lake Drive, Hawthorne, FL 32640 | 2015-06-01 |
| 1750575056 | Lenise Valma Thomas | Licensed Practical Nurse | 109 Juniper Drive, Hawthorne, FL 32640 | 2007-08-29 |
| 1023138708 | Brian Christopher Creghan I | Physician Assistant | 6435 Se Hwy 301, Hawthorne, FL 32640 | 2007-03-29 |
| 1275627275 | Charles Edward Peele | Chiropractor | 6005 Se Hwy 301, Suite 405a, Hawthorne, FL 32640 | 2006-10-03 |
| 1093123614 | Joseph J Ciccio | Physical Therapist | 19804 Ne 22nd Ln, Hawthorne, FL 32640-2900 | 2014-07-28 |
| 1073912184 | Kristen Tiurchy | Occupational Therapist | 19804 Ne 22nd Ln, Hawthorne, FL 32640-2900 | 2014-08-14 |
| 1306347919 | Myia Mccloud | Licensed Practical Nurse | 22421 Se 59th Pl, Hawthorne, FL 32640-3616 | 2018-02-28 |
| Find all providers in zip 32640 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.