Provider Demographics
NPI:1588727408
Name:RICES PHARMACY INC
Entity type:Organization
Organization Name:RICES PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:
Authorized Official - Last Name:HEBERT
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:603-882-5153
Mailing Address - Street 1:PO BOX 1103
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03061-1103
Mailing Address - Country:US
Mailing Address - Phone:603-345-0999
Mailing Address - Fax:603-546-7711
Practice Address - Street 1:59 MAIN ST
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03064-2726
Practice Address - Country:US
Practice Address - Phone:603-882-5153
Practice Address - Fax:603-882-2217
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2010-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336C0004X, 3336L0003X, 333600000X
NH04813336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3000306OtherNCPDP PROVIDER IDENTIFICATION NUMBER
NH80877556Medicaid
0146510001Medicare NSC