NPIMap

Organization Active NPI

Rural Health Care, Inc.

Doing business as Aza Health

  • Community/Retail Pharmacy
  • Green Cove Springs, FL
National Provider Identifier
1518394477
Registry record updated Feb 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PH0027105 Issued in FL
Legal business name
RURAL HEALTH CARE, INC.
Doing business as
Aza Health
Practice address
1305 N Orange Ave
Green Cove Springs, FL 32043-2547
Phone
(904) 284-5904
Fax
(904) 284-5905
NPI assigned
Oct 8, 2013
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
Mr. Larry William Pederson, RPH, CPHNPI 1023187101
Title
VP/Cpo
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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PH0027105 FL Primary

Addresses

Primary practice location

1305 N Orange Ave
Green Cove Springs, FL 32043-2547

Mailing address

PO Box 817
Palatka, FL 32178-0817
Phone (386) 328-0108

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": "1381190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581552000000",
    "number": "1518394477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 817",
            "city": "PALATKA",
            "state": "FL",
            "postal_code": "321780817",
            "telephone_number": "386-328-0108",
            "fax_number": "386-325-1086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 N ORANGE AVE",
            "city": "GREEN COVE SPRINGS",
            "state": "FL",
            "postal_code": "320432547",
            "telephone_number": "904-284-5904",
            "fax_number": "904-284-5905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RURAL HEALTH CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-08",
        "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": "VP/CPO",
        "authorized_official_telephone_number": "386-328-0558",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH, CPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PH0027105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aza Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Green Cove Springs, 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.