# NORTH FLORIDA RURAL HEALTH CORP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912641341
- **Authorized official:** MR. TRACI THOMPSON MD (CMO)
- **Authorized official phone:** (410) 493-3901

## Contact information

- **Practice address:** 680 MAPLE ST, CHATTAHOOCHEE, FL 32324-1826
- **Practice address phone:** (850) 999-3181
- **Mailing address:** 600 34TH ST S, SAINT PETERSBURG, FL 33711-1722
- **Mailing address phone:** (850) 999-3181

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | — |
| 261QD0000X | Dental Clinic/Center | — | NULL | — |
| 261QF0400X | Federally Qualified Health Center (FQHC) | — | NULL | — |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |
| 347B00000X | Bus | — | NULL | — |

## Other

- **Enumeration date:** 04/22/2022
- **Last updated:** 02/20/2024