Provider Demographics
NPI:1235290149
Name:RURAL HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:RURAL HEALTH SERVICES, INC.
Other - Org Name:MARGARET J. WESTON PHARMACY
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:L
Authorized Official - Last Name:COLEMAN
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:803-593-9283
Mailing Address - Street 1:PO BOX 277
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:SC
Mailing Address - Zip Code:29822-0277
Mailing Address - Country:US
Mailing Address - Phone:803-593-9283
Mailing Address - Fax:803-593-0607
Practice Address - Street 1:4645 AUGUSTA ROAD
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:SC
Practice Address - Zip Code:29822
Practice Address - Country:US
Practice Address - Phone:803-593-9283
Practice Address - Fax:803-593-0607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC500030583336C0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC730581Medicaid