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Angela Yvonne Rice

Family Medicine

Allopathic & Osteopathic Physicians

94 Marie Langdon Dr Ste 2, Manchester, KY 40962-6345

PECOS Enrollment

This provider is enrolled in PECOS as ANGELA RICE.

Based on the most recent information from CMS, provider Angela Yvonne Rice is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 3:36 PM.

Profile Details

Provider ID
1134231822
Provider Type
Individual
Full Name
Rice, Angela Yvonne
Credential
DO

Gender
Female
Sole Proprietor
No
Enumeration Date
8/31/2006
Last Updated
4/16/2019

Contact Information

Practice Location

94 Marie Langdon Dr Ste 2, Manchester, KY 40962-6345

(606) 599-9955

Unlisted Fax

Mailing Location

509 Memorial Dr, Ste 2, Manchester, KY 40962-6196

(606) 599-9955

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207Q00000X Primary	Description Family Medicine Allopathic & Osteopathic Physicians	License 02905 Kentucky
Code 207QA0000X	Description Family Medicine Allopathic & Osteopathic Physicians	License 02905 Kentucky
Code 207QA0401X	Description Family Medicine Allopathic & Osteopathic Physicians	License 02905 Kentucky
Code 207QA0505X	Description Family Medicine Allopathic & Osteopathic Physicians	License 02905 Kentucky
Code 207QG0300X	Description Family Medicine Allopathic & Osteopathic Physicians	License 02905 Kentucky
Code 207QS0010X	Description Family Medicine Allopathic & Osteopathic Physicians	License 02905 Kentucky

Provider Identifiers

ID	Description	Issuer
ID 64102478	Description Medicaid	Issuer Unlisted Kentucky

Angela Yvonne Rice

PECOS Enrollment

Profile Details

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