Provider Demographics
NPI:1053362111
Name:RURAL HEALTH SERVICES INC
Entity type:Organization
Organization Name:RURAL HEALTH SERVICES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:EMANUEL- MCCLAIN
Authorized Official - Suffix:
Authorized Official - Credentials:MPH
Authorized Official - Phone:803-380-7012
Mailing Address - Street 1:120 DARLINGTON DRIVE
Mailing Address - Street 2:
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29803
Mailing Address - Country:US
Mailing Address - Phone:803-641-1404
Mailing Address - Fax:803-641-1410
Practice Address - Street 1:120 DARLINGTON DRIVE
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29803
Practice Address - Country:US
Practice Address - Phone:803-641-1404
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-13
Last Update Date:2012-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC046051Medicaid
SCFQC095Medicaid
RHC078OtherSC MEDICAID
SC046051Medicaid
SCFQC095Medicaid
428909Medicare PIN