Provider Demographics
NPI:1548376023
Name:RICE OPTOMETRY, LLC
Entity type:Organization
Organization Name:RICE OPTOMETRY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:JEANNE
Authorized Official - Middle Name:A
Authorized Official - Last Name:RICE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:218-878-0287
Mailing Address - Street 1:218 DEAN RD
Mailing Address - Street 2:
Mailing Address - City:ESKO
Mailing Address - State:MN
Mailing Address - Zip Code:55733-9729
Mailing Address - Country:US
Mailing Address - Phone:218-878-0287
Mailing Address - Fax:
Practice Address - Street 1:1308 HIGHWAY 33 S
Practice Address - Street 2:
Practice Address - City:CLOQUET
Practice Address - State:MN
Practice Address - Zip Code:55720-2653
Practice Address - Country:US
Practice Address - Phone:218-878-1951
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2829152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNCO3664Medicare ID - Type UnspecifiedGROUP #
MNU86786Medicare UPIN