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/CPO)
(386) 328-0558
Entity
Organization
Contact information
Practice address
306 UNION AVE, CRESCENT CITY, FL 32112-4432
(386) 698-2368
(386) 698-4343
Mailing address
PO BOX 817, PALATKA, FL 32178-0817
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
PH0016495
FL
3336C0003X
Community/Retail Pharmacy
Primary
PH0016495
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
021632100
—
FL
05
—
021632179
—
FL
01
—
1085960
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
10/20/2006
Last updated
02/07/2020
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