1326102716 NPI number — RURAL HEALTH, INC

Table of content: (NPI 1326102716)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326102716 NPI number — RURAL HEALTH, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RURAL HEALTH, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1326102716
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/11/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
513 N MAIN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ANNA
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
62906-1668
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
618-833-4471
Provider Business Mailing Address Fax Number:
618-833-8878

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3303 LOGAN DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HERRIN
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
62948-3732
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
618-993-5767
Provider Business Practice Location Address Fax Number:
618-993-4005
Provider Enumeration Date:
12/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
FLAMM
Authorized Official First Name:
CYNTHIA
Authorized Official Middle Name:
K
Authorized Official Title or Position:
C. E. O.
Authorized Official Telephone Number:
618-833-4471

Provider Taxonomy Codes

  • Taxonomy code: 261QR1300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 111760 . This is a "HEALTHLINK" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 055761 . This is a "HEALTH ALLIANCE" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".




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