Healthcare Provider Details

I. General information

NPI: 1366545212
Provider Name (Legal Business Name): ERIC C RICE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2006
Last Update Date: 09/14/2020
Certification Date: 09/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 MERCY DR
COUNCIL BLUFFS IA
51503-3128
US

IV. Provider business mailing address

7500 MERCY RD
OMAHA NE
68124-2319
US

V. Phone/Fax

Practice location:
  • Phone: 855-524-4001
  • Fax: 712-325-2499
Mailing address:
  • Phone: 855-524-4001
  • Fax: 402-398-5589

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number20464
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number20464
License Number StateNE
# 3
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMD-40116
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: