Provider Demographics
NPI:1922730472
Name:TRICE FAMILY CARE
Entity Type:Organization
Organization Name:TRICE FAMILY CARE
Other - Org Name:N/A
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:QUAMIIR
Authorized Official - Middle Name:RYSHI
Authorized Official - Last Name:TRICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-844-6369
Mailing Address - Street 1:5927 N NORWOOD ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19138-2919
Mailing Address - Country:US
Mailing Address - Phone:267-844-6369
Mailing Address - Fax:
Practice Address - Street 1:5927 N NORWOOD ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19138-2919
Practice Address - Country:US
Practice Address - Phone:267-844-6369
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-24
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103750141-0001Medicaid