Provider Demographics
NPI:1760882724
Name:RICE, COURTNEY ALYSSA (PHARMD)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:ALYSSA
Last Name:RICE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 PROXIMITY DR APT 819
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29414-7945
Mailing Address - Country:US
Mailing Address - Phone:724-456-2664
Mailing Address - Fax:
Practice Address - Street 1:2020 PROXIMITY DR APT 819
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29414-7945
Practice Address - Country:US
Practice Address - Phone:724-456-2664
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-27
Last Update Date:2014-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC35637183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist