ROSE MEDICAL ASSOCIATION, INC.; NPI #1144741844

Contact Information

ROSE MEDICAL ASSOCIATION, INC.

209 W ROMEO B GARRETT AVE
PEORIA, IL 61605-2502

Phone: 309-686-1600
Fax: 309-686-1605
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Addiction Medicine	2084A0401X	79	Physician/Addiction Medicine

Indicates primary specialty

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NPI Profile & details for ROSE MEDICAL ASSOCIATION, INC.

NPI # 1144741844

LBN Legal business name ROSE MEDICAL ASSOCIATION, INC.

Authorized official ERNEST ROSE - (MEDICAL DIRECTOR / CEO)

Entity Organization

Organization subpart ¹ No

Enumeration date 07/03/2017

Last updated 07/21/2022 - About 4 years ago

Identifiers

License #

036-059239

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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