Blake Rice
Individual provider Active NPI Pharmacist · Riddle, OR
NPI 1063437184 · NPPES record last updated May 28, 2008
Key facts
- NPI
- 1063437184
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- RPH0006533 (OR)
- Practice address
- 142 Main Street
Riddle, OR 97467 - Phone
- (541) 874-2406
- Fax
- (541) 874-3256
- NPI assigned
- Jul 12, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH0006533 | OR | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Riddle Pharmacy LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH0006533 | OR | Yes |
Addresses
Primary practice location
142 Main Street
Riddle, OR 97467
Mailing address
PO Box 826
Riddle, OR 97469-0826
Phone (541) 874-2406
Other providers in Riddle, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 28, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.