MEDICARE: DR. TIFFANY MARIE RICO 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	30439	OH

General Provider Information

NPI Number	:	1558962480
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TIFFANY MARIE RICO PHARMD

Provider Business Mailing Address
First Line	:	6680 WILSON LN
Second Line	:
City	:	NASHPORT
State	:	OH
Zip	:	43830-9141
Country	:	US
Telephone Number	:	740-310-2763
Fax Number	:

Provider Business Practice Location Address
First Line	:	945 BETHESDA DR STE 20
Second Line	:
City	:	ZANESVILLE
State	:	OH
Zip	:	43701-0801
Country	:	US
Telephone Number	:	740-454-4044
Fax Number	:	740-455-4912

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

Provider Enumeration Date	:	11/06/2020
Last Update Date	:	06/03/2026

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