Provider Demographics
NPI:1508469297
Name:RICE, HERBERT WAYNE (RPH)
Entity Type:Individual
Prefix:
First Name:HERBERT
Middle Name:WAYNE
Last Name:RICE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 459
Mailing Address - Street 2:
Mailing Address - City:KUTTAWA
Mailing Address - State:KY
Mailing Address - Zip Code:42055-0459
Mailing Address - Country:US
Mailing Address - Phone:270-388-7371
Mailing Address - Fax:270-388-5675
Practice Address - Street 1:86 CEDAR ST
Practice Address - Street 2:
Practice Address - City:KUTTAWA
Practice Address - State:KY
Practice Address - Zip Code:42055-6287
Practice Address - Country:US
Practice Address - Phone:270-388-7371
Practice Address - Fax:270-388-5675
Is Sole Proprietor?:No
Enumeration Date:2020-11-17
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY010652183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY010652OtherKY BOARD OF PHARMACY