Healthcare Provider Details

I. General information

NPI: 1720186760
Provider Name (Legal Business Name): ROVIN INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 10/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2819 5TH AVE
HUNTINGTON WV
25702-1435
US

IV. Provider business mailing address

2819 5TH AVE
HUNTINGTON WV
25702-1435
US

V. Phone/Fax

Practice location:
  • Phone: 304-522-9411
  • Fax: 304-522-4651
Mailing address:
  • Phone: 304-522-9411
  • Fax: 304-522-4651

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code156FX1800X
TaxonomyOptician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: MARK MORRIS
Title or Position: OFFICE MANAGER
Credential:
Phone: 304-522-9411