Provider Demographics
NPI:1033160684
Name:MARION RURAL HEALTH,INC
Entity Type:Organization
Organization Name:MARION RURAL HEALTH,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTER
Authorized Official - Prefix:MS
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:AMERSON
Authorized Official - Last Name:SPOGEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-625-7777
Mailing Address - Street 1:15932 E HIGHWAY 40
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34488-5144
Mailing Address - Country:US
Mailing Address - Phone:352-625-7777
Mailing Address - Fax:352-625-1970
Practice Address - Street 1:15932 E HIGHWAY 40
Practice Address - Street 2:
Practice Address - City:SILVER SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34488-5144
Practice Address - Country:US
Practice Address - Phone:352-625-7777
Practice Address - Fax:352-625-1970
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-16
Last Update Date:2013-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL660054900Medicaid
FL103921Medicare ID - Type UnspecifiedRURAL HEALTH CLINIC