Provider Demographics
NPI:1417174657
Name:RURAL MEDICAL SERVICES, INC.
Entity Type:Organization
Organization Name:RURAL MEDICAL SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:A
Authorized Official - Last Name:STANIFER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-613-3300
Mailing Address - Street 1:PO BOX 577
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37822-0577
Mailing Address - Country:US
Mailing Address - Phone:423-613-3300
Mailing Address - Fax:423-623-4088
Practice Address - Street 1:613 W BROADWAY
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:TN
Practice Address - Zip Code:37821-9032
Practice Address - Country:US
Practice Address - Phone:423-613-3300
Practice Address - Fax:423-623-4088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)