Organization
RURAL HEALTH CARE, INC.
Active
Other names
Aza Health
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY WILLIAM PEDERSON RPH (CHIEF PHARMACY OFFICER)
(386) 328-0558
Entity
Organization
Contact information
Practice address
100 COMMERCIAL DR, KEYSTONE HEIGHTS, FL 32656-6802
(352) 473-7243
(352) 473-9149
Mailing address
100 COMMERCIAL DR, KEYSTONE HEIGHTS, FL 32656-6802
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
PH19386
FL
3336C0003X
Community/Retail Pharmacy
Primary
PH19386
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
026423700
—
FL
05
—
026423790
—
FL
01
—
1099488
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
10/20/2006
Last updated
02/13/2020
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