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. (PRESIDENT/CHIEF EXECUTIVE OFFICER)
(386) 328-0108
Entity
Organization
Contact information
Practice address
1213 STATE ROAD 20, INTERLACHEN, FL 32148-2737
(386) 684-4914
(386) 684-4154
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
L8000010911
FL
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
029543402
—
FL
05
—
037641801
—
FL
05
—
101251779
—
FL
01
—
99262
BLUE CROSS BLUE SHIELD
FL
01
—
CF6528
MEDICARE RAILROAD
FL
Enumeration date
02/28/2006
Last updated
02/13/2020
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