Provider Demographics
NPI:1851985055
Name:RICE, CASEY GABRIELLE (PHARMD)
Entity Type:Individual
Prefix:
First Name:CASEY
Middle Name:GABRIELLE
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 1:131 OAK CIR
Mailing Address - Street 2:
Mailing Address - City:GLENNVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30427-2739
Mailing Address - Country:US
Mailing Address - Phone:912-237-8375
Mailing Address - Fax:
Practice Address - Street 1:1422 W OGLETHORPE HWY STE A
Practice Address - Street 2:
Practice Address - City:HINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:31313-5633
Practice Address - Country:US
Practice Address - Phone:912-877-9818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-27
Last Update Date:2021-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH032294183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist