Organization
RURAL HEALTH CARE, INC.
Active
Other names
Aza Health
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY WILLIAM PEDERSON RPH, CPH (VP/CHIEF PHARMACY OFFICER)
(386) 328-0558
Entity
Organization
Contact information
Practice address
1425 DUNN AVE, DAYTONA BEACH, FL 32114-1437
(386) 323-9808
(386) 323-9810
Mailing address
1302 RIVER ST, PALATKA, FL 32177-5042
(386) 328-0558
(386) 328-9443
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH31307
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PH31307
DOH-BOARD OF PHARMACY
FL
Enumeration date
04/03/2018
Last updated
02/13/2020
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