Organization
RURAL HEALTH CARE, INC.
Active
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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