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General NPI Number Information
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NPI Number | 1306029251
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Entity Type | Organization
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Legal Business Name | ROSE EYE CARE, INC.
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Dates
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Enumeration Date | 12/14/2007
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Last Update Date | 07/31/2024
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Provider Practice Location Address
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Address Line | 14815 US HIGHWAY 19 S SUITE 1000
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City | THOMASVILLE
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State | GA
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Zip | 31792-4889
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Country | US
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Telephone | 229-227-9200
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Fax | 229-226-6057
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Provider Business Mailing Address
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Address Line | 14815 HWY. 19 SOUTH SUITE 1000
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City | THOMASVILLE
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State | GA
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Zip | 31792-4889
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Country | US
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Telephone | 229-227-9200
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Fax | 229-226-6057
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Authorized Official
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Title or Position | PRESIDENT
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Name | DAVID L GROSSWALD
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Credential | OD
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Telephone | 770-860-1919
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | OPT001177
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License Number State | GA
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