Provider Demographics
NPI:1972805257
Name:RICE, CHRIS ALAN (BS PHARMACY)
Entity type:Individual
Prefix:
First Name:CHRIS
Middle Name:ALAN
Last Name:RICE
Suffix:
Gender:M
Credentials:BS PHARMACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1540 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SWEET HOME
Mailing Address - State:OR
Mailing Address - Zip Code:97386-1614
Mailing Address - Country:US
Mailing Address - Phone:541-367-0675
Mailing Address - Fax:541-367-0678
Practice Address - Street 1:1540 MAIN ST
Practice Address - Street 2:
Practice Address - City:SWEET HOME
Practice Address - State:OR
Practice Address - Zip Code:97386-1614
Practice Address - Country:US
Practice Address - Phone:541-367-0675
Practice Address - Fax:541-367-0678
Is Sole Proprietor?:No
Enumeration Date:2010-11-19
Last Update Date:2010-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR6933183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist