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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