RURAL HEALTH CARE INCORPORATED (NPI# 1477529311) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477529311 |
| Entity Type | Organization |
| Organization Name | RURAL HEALTH CARE INCORPORATED |
| Other Organization Name | AZA HEALTH |
| Practice Address |
1213 State Road 20 Interlachen FL 32148-2737 |
| Mailing Address |
1302 River St Palatka FL 32177-5042 |
| Practice Telephone | 3866844914 |
| Practice Fax Number | 3866844154 |
| Mailing Telephone | 3863280108 |
| Mailing Fax Number | 3863251086 |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2020-02-13 |
| Authorized Official Name | MISS LAURA M. SPENCER (PRESIDENT/CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 3863280108 |
| Authorized Official Credential | C.E.O. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QC1500X |
Clinic/Center Specialization: Community Health |
L8000010911 | 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 | 037641801 | 05 | |
| FL | 101251779 | 05 | |
| FL | BLUE CROSS BLUE SHIELD | 99262 | 01 |
| FL | 029543402 | 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 |
|---|---|---|---|---|
| 1114994944 | Rural Health Care Incorporated | General Practice | 22066 Se 71st Avenue, Hawthorne, FL 32640-3969 | 2006-03-01 |
| 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 |
| 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 |
1213 STATE ROAD 20 |
| City | INTERLACHEN |
| State | FL |
| Zip Code | 32148-2737 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649245804 | Myriame Vastey | Family Medicine | 1213 State Road 20, Interlachen, FL 32148-2737 | 2006-02-21 |
| 1447790241 | Nicholas Bryan Sorensen | Pharmacist | 1213 State Road 20, Interlachen, FL 32148-2737 | 2017-02-28 |
| 1811387590 | Julie Elwood | Social Worker | 1213 State Road 20, Interlachen, FL 32148-2737 | 2015-02-02 |
| 1730498916 | Joseph Anthony Altamirando | Physician Assistant | 1213 State Road 20, Interlachen, FL 32148-2737 | 2010-10-05 |
| 1497838551 | Rural Health Care, Inc. | Pharmacy | 1213 State Road 20, Interlachen, FL 32148-2737 | 2006-10-23 |
| 1124116090 | John T Phipps | Social Worker | 1213 State Road 20, Interlachen, FL 32148-2737 | 2006-10-10 |
| 1831128560 | Jack Edward Pulwers Jr. | Internal Medicine | 1213 State Road 20, Interlachen, FL 32148-2737 | 2006-07-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730702978 | Able Behavioral Health Center | Registered Nurse | Orange Blossom Manor Mb4 P92, Blk 8, Interlachen, FL 32148 | 2020-05-22 |
| 1205307188 | Luis Miguel Nunez Arroyo | General Practice | 1114 Fl-20, Interlachen, FL 32148 | 2018-12-17 |
| 1023329067 | Metro Pharmaceutical Services Inc | Pharmacy | 126-1 South Cr 315, Interlachen, FL 32148 | 2010-06-24 |
| 1326118308 | Raymond S Rood IIi | Pharmacist | 1213 Hwy 20, Interlachen, FL 32148 | 2006-11-08 |
| 1609971431 | Holiday Cvs LLC | Pharmacy | 1141 Highway 20, Interlachen, FL 32148 | 2006-09-14 |
| 1124026117 | Gerardo Antonio Pedroza-sierra | General Practice | 1114 Sr 20, Suite 300, Interlachen, FL 32148 | 2005-07-13 |
| 1487054680 | Tracy Lynn Steinmetz | Community Health Worker | 822 Selma Ave, Interlachen, FL 32148-2570 | 2014-08-26 |
| 1063749737 | Norma Iris Lopez-banuchi | Licensed Practical Nurse | 194 Reaves Ave, Interlachen, FL 32148-3632 | 2009-11-17 |
| 1740721968 | Meagan Feibelman | Specialist/Technologist | 838 Lake Shore Ter, Interlachen, FL 32148-4301 | 2017-03-20 |
| 1861646663 | Starr Hancock Gainey | Community Health Worker | 403 Walker Dr, Interlachen, FL 32148-4370 | 2008-11-06 |
| Find all providers in zip 32148 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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| Find all providers with the same taxonomy | ||||
| City | INTERLACHEN |
| Zip Code | 32148 |
Please comment or provide details below to improve the information on RURAL HEALTH CARE INCORPORATED.
| 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.