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
1213 STATE ROAD 20, INTERLACHEN, FL 32148-2737
(386) 684-2407
(386) 684-4701
Mailing address
PO BOX 817, PALATKA, FL 32178-0817
(386) 328-0558
(386) 328-9443
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
PH11219
FL
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101251700
—
FL
05
—
101251779
—
FL
01
—
1068243
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
10/23/2006
Last updated
02/07/2020
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