1710164256 NPI number — PATRICIA M RICE L.I.S.W. -S

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710164256 NPI number — PATRICIA M RICE L.I.S.W. -S

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RICE
Provider First Name:
PATRICIA
Provider Middle Name:
M
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
L.I.S.W. -S
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
RICE, RSM
Provider Other First Name:
SISTER PATRICIA
Provider Other Middle Name:
M
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1710164256
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/10/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8595 BEECHMONT AVE
Provider Second Line Business Mailing Address:
STE. 303
Provider Business Mailing Address City Name:
CINCINNATI
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45255-4783
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
513-288-0832
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8595 BEECHMONT AVE
Provider Second Line Business Practice Location Address:
STE. 303
Provider Business Practice Location Address City Name:
CINCINNATI
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45255-4783
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-288-0832
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/28/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  I 0004898 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 104100000X , with the licence number: I0004898 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2801052 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




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