Rice Home Medical

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Home > Provider Portal > Submit an Order

Submit an Order

Submit an Order via Fax

You can download the order form below, fill it out completely, and fax it back to us at 320.222.2992.

CADD Pump & Supplies RX Cervical Traction RX Compression Garment RX Enteral Nutrition RX Generic DME Supplies RX Group 1 or 2 Support Surface RX Hospital Bed RX Manual Wheelchair RX Mastectomy Supplies RX Nebulizer RX Negative Pressure Wound Therapy (NPWT) RX Overnight Oximetry RX Oxygen RX PAP and Supplies RX Patient Lifts RX Pneumatic Compression RX Power Mobility – 7 Element Order Seat Lift RX Surgical Dressings RX TENS Unit RX Urologic RX

 


 

Submit an Order Online

Here you will find links to the online forms for submitting orders to us. These forms are HIPAA compliant and are encrypted at four points in the process. The submitted forms are password protected and only accessible to those within Rice Home Medical.

CADD Pump & Supplies RX Cervical Traction RX Compression Garment RX Generic DME Supplies RX Group 1 or 2 Support Surface RX Hospital Bed RX Manual Wheelchair RX Mastectomy Supplies RX Nebulizer RX Overnight Oximetry RX Oxygen RX PAP and Supplies RX Patient Lift RX Power Mobility – 7 Element Order Seat Lift Mechanism RX Surgical Dressings RX TENS Unit RX Urologic RX

Need Assistance? Ready to Order?

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Need Assistance? Ready to Order?

Call us toll-free at: 1.800.637.7795

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During open store hours, simply enter your phone number, select an option from the drop down menu and press the Call Me button. Our next available Customer Service Representative will give you a call.

Store Hours: Monday – Friday: 8:30 am – 5:00 pm