Provider Demographics
NPI:1265420004
Name:RURAL HEALTH CARE, INC.
Entity type:Organization
Organization Name:RURAL HEALTH CARE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:RITA
Authorized Official - Middle Name:R
Authorized Official - Last Name:WAGNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-223-2200
Mailing Address - Street 1:608 E GARFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:GETTYSBURG
Mailing Address - State:SD
Mailing Address - Zip Code:57442-1325
Mailing Address - Country:US
Mailing Address - Phone:605-765-2273
Mailing Address - Fax:605-765-2273
Practice Address - Street 1:608 E GARFIELD AVE
Practice Address - Street 2:
Practice Address - City:GETTYSBURG
Practice Address - State:SD
Practice Address - Zip Code:57442-1325
Practice Address - Country:US
Practice Address - Phone:605-765-2273
Practice Address - Fax:605-765-2273
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD5350190Medicaid
SD4997849OtherBCBS GROUP PROVIDER NUMBE
SD5350190Medicaid
SD431821Medicare ID - Type UnspecifiedUGS MEDICARE PROVIDER NUM