Provider Demographics
NPI:1760455406
Name:RICE, PATRICK
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:
Last Name:RICE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 HOWARD AVE
Mailing Address - Street 2:SUITE F2
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16601-4810
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:501 HOWARD AVE
Practice Address - Street 2:SUITE F2
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16601-4810
Practice Address - Country:US
Practice Address - Phone:814-889-2701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD051343L207QH0002X, 207QH0002X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA080072199OtherRAILROAD MEDICARE - AFP
PA110610OtherUNISON OBSTETRICS
PA85705OtherUNISON OB (AFP)
PA1007278290092Medicaid
PA74022OtherUNISON (AFP)
BR3802990OtherDEA
PA2057625OtherHIGHMARK BC/BS
GACA9269OtherRAILROAD MEDICARE - AFP GROUP NUMBER
PAP000527OtherGATEWAY HEALTH PLAN
PA7355-W407OtherGEISINGER (WBG)
GACD7397OtherRAILROAD MEDICARE-GROUP NUMBER-WFP
TXT0133773OtherDPS
PA0014680950004 (AFP)Medicaid
PA1007278290086Medicaid
TX165234901Medicaid
PA0014680950001 (WBG)Medicaid
PA110609OtherUNISON
PA203693OtherUPMC HEALTH PLAN
PA7355-W402OtherGEISINGER (AFP)
PA7355-W407OtherGEISINGER (WBG)
PA719342Medicare PIN
F89867Medicare UPIN
PA1007278290092Medicaid
PA7355-W402OtherGEISINGER (AFP)
PA531774KUNMedicare PIN