RURAL HEALTH CARE, INCORPORATED (NPI# 1528204419) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528204419 |
| Entity Type | Organization |
| Organization Name | RURAL HEALTH CARE, INCORPORATED |
| Other Organization Name | AZA HEALTH |
| Practice Address |
22066 Se 71st Ave Hawthorne FL 32640-3969 |
| Mailing Address |
Po Box 817 Palatka FL 32178-0817 |
| Practice Telephone | 3524815640 |
| Practice Fax Number | 3524815641 |
| Mailing Telephone | 3863280558 |
| Mailing Fax Number | 3863289443 |
| Enumeration Date | 2008-12-23 |
| Last Update Date | 2020-02-13 |
| Authorized Official Name | LARRY W PEDERSON (VP/CPO) |
| Authorized Official Telephone | 3863280558 |
| Authorized Official Credential | AA,BA,BSP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | PH23758 | FL | Suppliers |
| N | 3336S0011X |
Pharmacy Specialization: Specialty Pharmacy |
Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
PH0023758 | FL | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 000602300 | 05 | |
| NCPDP CHAIN CODE | 935 | 01 | |
| NCPDP | 1041071 | 01 | |
| DEA | FR1193337 | 01 |
| Other Name | Type Code |
|---|---|
| Aza Health | Doing Business As Name - Organization |
| AZALEA HEALTH | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568712693 | Rural Health Care, Incorporated | Pharmacy | 105 Whitehall Dr, Suites 109-114, St Augustine, FL 32086-5269 | 2012-09-17 |
| 1679822993 | Rural Health Care, Incorporated | Clinic/Center | 201 West Lattin Street, Hastings, FL 32145-4111 | 2012-08-31 |
| 1629324751 | Rural Health Care, Incorporated | Clinic/Center | 105 Whitehall Dr, Suites 109-114, St Augustine, FL 32086-5269 | 2012-07-26 |
| 1316020472 | Rural Health Care, Incorporated | Pharmacy | 1302 River St, Palatka, FL 32177-5042 | 2006-10-23 |
| Street Address |
22066 SE 71ST AVE |
| City | HAWTHORNE |
| State | FL |
| Zip Code | 32640-3969 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962401554 | Brian Scott Brooks | Physician Assistant | 22066 Se 71st Ave, Hawthorne, FL 32640-3969 | 2005-07-18 |
| 1316026610 | Nalini Lalit Sharma | Internal Medicine | 22066 Se 71st Ave, Hawthorne, FL 32640-3969 | 2006-11-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306303169 | Althea Pontoon | In Home Supportive Care | 144 Prairie Drive, Hawthorne, FL 32640 | 2019-02-27 |
| 1013446475 | Divine Care Services LLC | Home Health Aide | 21212 Se 62nd Ave, Hawthorne, FL 32640 | 2017-06-08 |
| 1073968715 | Crista Marina Ana Lucia Rosborough | Specialist | 21403 Se 70th Ave, Hawthorne, FL 32640 | 2016-05-02 |
| 1952781387 | Neil Franklin Letts | Ophthalmology | 160 Little Orange Lake Drive, Hawthorne, FL 32640 | 2015-06-01 |
| 1750575056 | Lenise Valma Thomas | Licensed Practical Nurse | 109 Juniper Drive, Hawthorne, FL 32640 | 2007-08-29 |
| 1023138708 | Brian Christopher Creghan I | Physician Assistant | 6435 Se Hwy 301, Hawthorne, FL 32640 | 2007-03-29 |
| 1275627275 | Charles Edward Peele | Chiropractor | 6005 Se Hwy 301, Suite 405a, Hawthorne, FL 32640 | 2006-10-03 |
| 1093123614 | Joseph J Ciccio | Physical Therapist | 19804 Ne 22nd Ln, Hawthorne, FL 32640-2900 | 2014-07-28 |
| 1073912184 | Kristen Tiurchy | Occupational Therapist | 19804 Ne 22nd Ln, Hawthorne, FL 32640-2900 | 2014-08-14 |
| 1306347919 | Myia Mccloud | Licensed Practical Nurse | 22421 Se 59th Pl, Hawthorne, FL 32640-3616 | 2018-02-28 |
| Find all providers in zip 32640 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730562695 | Cvs | Pharmacy | 4755 W. Rosecrans Ave, Hawthorne, CA 90505-5525 | 2015-07-09 |
| 1164670519 | Garfield Beach Cvs LLC | Pharmacy | 2700 W 120th St, Hawthorne, CA 90250-3388 | 2008-08-28 |
| 1952586323 | Walgreen Co | Pharmacy | 11983 Hawthorne Blvd, Hawthorne, CA 90250-3015 | 2008-01-04 |
| 1164558797 | Jose R Sardinas | Pharmacy | 11930 Hawthorne Blvd, Hawthorne, CA 90250-3016 | 2007-02-26 |
| 1245339449 | Tonaire Corporation | Pharmacy | 576 Lafayette Avenue, Hawthorne, NJ 07506-2423 | 2006-09-22 |
| 1649378134 | Garfield Beach Cvs LLC | Pharmacy | 4775 W Rosecrans Ave, Hawthorne, CA 90250-6842 | 2006-09-20 |
| 1194829051 | Holiday Cvs LLC | Pharmacy | 6025 Se Us Highway 301, Hawthorne, FL 32640-7316 | 2006-09-12 |
| 1487764098 | Costco Wholesale Corporation | Pharmacy | 14501 Hindry Ave, Hawthorne, CA 90250 | 2006-08-30 |
| 1235144247 | Walgreen Co | Pharmacy | 14250 Prairie Ave, Hawthorne, CA 90250-7908 | 2006-07-29 |
| 1306889787 | Garfield Beach Cvs LLC | Pharmacy | 3880 W Rosecrans Ave, Hawthorne, CA 90250-8018 | 2006-06-14 |
| Find all providers in HAWTHORNE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.