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Organization

RURAL HEALTH CARE INCORPORATED

Active
Other names
Aza Health
Organization subpart
No

Provider details

NPI number
Authorized official
LAURA M. SPENCER (CHIEF EXECUTIVE OFFICER)
(386) 328-0108
Entity
Organization

Contact information

Practice address
100 COMMERCIAL DR, KEYSTONE HEIGHTS, FL 32656-6802
(352) 473-6595
(352) 473-6597
Mailing address
1302 RIVER ST, PALATKA, FL 32177-5042
(386) 328-0108
(386) 325-1086

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
261QC1500X
Community Health Clinic/Center
L800009980
FL
261QF0400X
Federally Qualified Health Center (FQHC)
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
026423790
FL
05
029543405
FL
05
037641805
FL
01
DE2912
MEDICARE RAILROAD
FL
Enumeration date
02/28/2006
Last updated
02/13/2020
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