Healthcare Provider Details

I. General information

NPI: 1760455406
Provider Name (Legal Business Name): PATRICK RICE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2006
Last Update Date: 04/06/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 HOWARD AVE SUITE F2
ALTOONA PA
16601-4810
US

IV. Provider business mailing address

501 HOWARD AVE SUITE F2
ALTOONA PA
16601-4810
US

V. Phone/Fax

Practice location:
  • Phone: 814-889-2701
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License NumberMD051343L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: