MEDICARE: TARA RICE

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	374U00000X	Home Health Aide
2	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1730828252
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TARA RICE

Provider Business Mailing Address
First Line	:	PO BOX 505
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72203-0505
Country	:	US
Telephone Number	:	501-398-9518
Fax Number	:

Provider Business Practice Location Address
First Line	:	201 W BROADWAY ST STE G5
Second Line	:
City	:	NORTH LITTLE ROCK
State	:	AR
Zip	:	72114-5554
Country	:	US
Telephone Number	:	501-398-9518
Fax Number	:

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

Provider Enumeration Date	:	06/02/2022
Last Update Date	:	06/02/2022

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Directions to “ TARA RICE ” Practice Location

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