Organization
RURAL HEALTH CARE INCORPORATED
Active
Other names
Aza Health
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY PEDERSON (PHARMACY DIRECTOR)
(386) 328-0558
Entity
Organization
Contact information
Practice address
1425 DUNN AVE, DAYTONA BEACH, FL 32114
(386) 323-9808
(386) 323-9810
Mailing address
1425 DUNN AVE, DAYTONA BEACH, FL 32114-1437
(386) 323-9808
(386) 323-9810
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH31307
FL
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2176831
PK
—
Enumeration date
04/04/2018
Last updated
02/13/2020
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