MEDICARE: DR. KIMBERLY RENEE RICE PHARMD

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	183500000X	Pharmacist	11320	TN

General Provider Information

NPI Number	:	1144262221
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KIMBERLY RENEE RICE PHARMD

Provider Business Mailing Address
First Line	:	1314 ISLAND PL E
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38103-9023
Country	:	US
Telephone Number	:	901-522-9120
Fax Number	:

Provider Business Practice Location Address
First Line	:	1640 CENTURY CENTER PKWY STE 101
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38134-8822
Country	:	US
Telephone Number	:	901-385-3600
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/12/2006
Last Update Date	:	03/19/2010

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