MEDICARE: T & R ROSE,LLC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	335E00000X	Prosthetic/Orthotic Supplier
2	332BC3200X	Customized Equipment (DME)

General Provider Information

NPI Number	:	1487984217
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	T & R ROSE,LLC.

Provider Business Mailing Address
First Line	:	3 N VIRGINIA ST
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89501-1403
Country	:	US
Telephone Number	:	775-337-0333
Fax Number	:	775-337-0306

Provider Business Practice Location Address
First Line	:	3 N VIRGINIA ST
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89501-1403
Country	:	US
Telephone Number	:	775-337-0333
Fax Number	:	775-337-0306

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	REGINA ROSE
Credential	:
Telephone Number	:	775-337-0333

Provider Enumeration Date	:	12/29/2009
Last Update Date	:	12/29/2009

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Directions to “T & R ROSE,LLC. ” Practice Location

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