NPIMap

Organization Active NPI

Rural Health Care, Inc.

Doing business as Aza Health

  • Community/Retail Pharmacy
  • Keystone Heights, FL
National Provider Identifier
1306928197
Registry record updated Feb 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PH19386 Issued in FL
Legal business name
RURAL HEALTH CARE, INC.
Doing business as
Aza Health
Practice address
100 Commercial Dr
Keystone Heights, FL 32656-6802
Phone
(352) 473-7243
Fax
(352) 473-9149
NPI assigned
Oct 20, 2006
Last updated
Feb 13, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Larry William Pederson, RPHNPI 1023187101
Title
Chief Pharmacy Officer
Phone
(386) 328-0558

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X PH19386 FL
Community/Retail Pharmacy 3336C0003X PH19386 FL Primary

Addresses

Primary practice location

100 Commercial Dr
Keystone Heights, FL 32656-6802

Mailing address

100 Commercial Dr
Keystone Heights, FL 32656-6802

Other identifiers 3

IdentifierTypeStateIssuer
1099488OtherOTHER ID NUMBER-COMMERCIAL NUMBER
026423700MedicaidFL
026423790MedicaidFL

Other names 1

  • Aza Health Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Family Medical Ctr25 organizations share this tax ID, including this one

Other organizations with this tax ID 24

Organizations that report the same tax identification number in the National Provider Directory.

View all 24

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581552000000",
    "number": "1306928197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 COMMERCIAL DR",
            "city": "KEYSTONE HEIGHTS",
            "state": "FL",
            "postal_code": "326566802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 COMMERCIAL DR",
            "city": "KEYSTONE HEIGHTS",
            "state": "FL",
            "postal_code": "326566802",
            "telephone_number": "352-473-7243",
            "fax_number": "352-473-9149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RURAL HEALTH CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-20",
        "last_updated": "2020-02-13",
        "certification_date": "2020-02-13",
        "status": "A",
        "authorized_official_last_name": "PEDERSON",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "CHIEF PHARMACY OFFICER",
        "authorized_official_telephone_number": "386-328-0558",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "FL",
            "license": "PH19386",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PH19386",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "1099488",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "026423700",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "026423790",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aza Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Keystone Heights, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.