Healthcare Provider Details

I. General information

NPI: 1487984217
Provider Name (Legal Business Name): T & R ROSE,LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2009
Last Update Date: 12/29/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 N VIRGINIA ST
RENO NV
89501-1403
US

IV. Provider business mailing address

3 N VIRGINIA ST
RENO NV
89501-1403
US

V. Phone/Fax

Practice location:
  • Phone: 775-337-0333
  • Fax: 775-337-0306
Mailing address:
  • Phone: 775-337-0333
  • Fax: 775-337-0306

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: REGINA ROSE
Title or Position: MANAGING MEMBER
Credential:
Phone: 775-337-0333