Provider Demographics
NPI:1891100350
Name:RICE, SANDRA L (RPH)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:L
Last Name:RICE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:296 BEDFORD ST
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06901-1720
Mailing Address - Country:US
Mailing Address - Phone:203-327-4479
Mailing Address - Fax:203-975-0427
Practice Address - Street 1:296 BEDFORD ST
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06901-1720
Practice Address - Country:US
Practice Address - Phone:203-327-4479
Practice Address - Fax:203-975-0427
Is Sole Proprietor?:No
Enumeration Date:2014-06-24
Last Update Date:2017-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH021056183500000X
AL9690183500000X
FLPS17747183500000X
CTPCT.0013497183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist