MEDICARE: DR. JACQUELYN KRISTEN RICE PHARM.D.

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	013296	KY

General Provider Information

NPI Number	:	1508084088
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JACQUELYN KRISTEN RICE PHARM.D.

Provider Business Mailing Address
First Line	:	394 SHADY CLIFF RD
Second Line	:
City	:	LEWISBURG
State	:	KY
Zip	:	42256-7811
Country	:	US
Telephone Number	:	270-657-8409
Fax Number	:

Provider Business Practice Location Address
First Line	:	201 S MAIN ST
Second Line	:
City	:	GREENVILLE
State	:	KY
Zip	:	42345-1507
Country	:	US
Telephone Number	:	270-338-4241
Fax Number	:

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

Provider Enumeration Date	:	04/23/2007
Last Update Date	:	04/30/2012

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