Organization
RURAL HEALTH CARE INCORPORATED
Active
Other names
Aza Health
Organization subpart
No
Provider details
NPI number
Authorized official
MISS LAURA M. SPENCER (CHIEF EXECUTIVE OFFICER)
(386) 328-0108
Entity
Organization
Contact information
Practice address
405 ELM STREET, WELAKA, FL 32193
(386) 467-3171
(386) 325-1086
Mailing address
1302 RIVER ST, PALATKA, FL 32177-5042
(386) 328-0108
(386) 325-1086
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
—
—
261QC1500X
Community Health Clinic/Center
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0295434-11
—
FL
05
—
0295434-12
—
FL
01
—
CF6528
MEDICARE RAILROAD
FL
Enumeration date
07/13/2007
Last updated
02/13/2020
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