Organization
RURAL HEALTH CARE INCORPORATED
Active
Other names
Aza Health
Organization subpart
No
Provider details
NPI number
Authorized official
MISS LAURA M SPENCER C.E.O. (CHIEF EXECUTIVE OFFICER)
(386) 328-0108
Entity
Organization
Contact information
Practice address
306 UNION AVE, CRESCENT CITY, FL 32112-4432
(386) 698-1232
(386) 698-4154
Mailing address
1302 RIVER ST, PALATKA, FL 32177-5042
(386) 328-0108
(386) 325-1086
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
L8000010912
FL
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
021632179
—
FL
05
—
029543403
—
FL
05
—
037641803
—
FL
01
—
CF6528
MEDICARE RAILROAD
FL
Enumeration date
03/03/2006
Last updated
02/13/2020
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