Provider Demographics
NPI:1144565748
Name:ROSE GYNECOLOGY LLC
Entity Type:Organization
Organization Name:ROSE GYNECOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:DR
Authorized Official - First Name:MADELEINE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:513-321-7673
Mailing Address - Street 1:2730 OBSERVATORY AVE
Mailing Address - Street 2:1 ST FL
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45208-2108
Mailing Address - Country:US
Mailing Address - Phone:513-321-7673
Mailing Address - Fax:
Practice Address - Street 1:2730 OBSERVATORY AVE
Practice Address - Street 2:1 ST FL
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45208-2108
Practice Address - Country:US
Practice Address - Phone:513-321-7673
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-07
Last Update Date:2012-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35082651207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty