Provider Demographics
NPI:1487848883
Name:RICE'S SHOES
Entity Type:Organization
Organization Name:RICE'S SHOES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:VOUGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-963-9273
Mailing Address - Street 1:62 MICHIGAN AVE W
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49017-3604
Mailing Address - Country:US
Mailing Address - Phone:269-963-9273
Mailing Address - Fax:
Practice Address - Street 1:62 MICHIGAN AVE W
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49017-3604
Practice Address - Country:US
Practice Address - Phone:269-963-9273
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-29
Last Update Date:2008-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
6044920001Medicare NSC