MEDICARE: PHILIP A RICH,MD PROFESSIONAL CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	3995	NV

General Provider Information

NPI Number	:	1760663702
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHILIP A RICH,MD PROFESSIONAL CORPORATION

Provider Business Mailing Address
First Line	:	628 LAKE STREET
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89501-1020
Country	:	US
Telephone Number	:	775-329-1717
Fax Number	:	775-329-2067

Provider Business Practice Location Address
First Line	:	628 LAKE STREET
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89501-1020
Country	:	US
Telephone Number	:	775-329-1717
Fax Number	:	775-329-2067

Authorized Official
Title or Position	:	CEO
Name	:	MR. PHILP A RICH
Credential	:	MD
Telephone Number	:	775-329-1717

Provider Enumeration Date	:	11/19/2007
Last Update Date	:	08/23/2011

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