Provider Demographics
NPI:1215969803
Name:RURAL HEALTH SERVICES, INC.
Entity type:Organization
Organization Name:RURAL HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAM
Authorized Official - Middle Name:K
Authorized Official - Last Name:PURI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:478-628-1636
Mailing Address - Street 1:PO BOX 39
Mailing Address - Street 2:
Mailing Address - City:GORDON
Mailing Address - State:GA
Mailing Address - Zip Code:31031-0039
Mailing Address - Country:US
Mailing Address - Phone:478-628-1636
Mailing Address - Fax:478-628-1639
Practice Address - Street 1:127 MAIN ST
Practice Address - Street 2:
Practice Address - City:GORDON
Practice Address - State:GA
Practice Address - Zip Code:31031-3841
Practice Address - Country:US
Practice Address - Phone:478-628-1636
Practice Address - Fax:478-628-1639
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA058125207R00000X
GA021573207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Not Answered207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Multi-Specialty