Provider Demographics
NPI:1629550140
Name:THE ROSE HEARING GROUP , LLC
Entity Type:Organization
Organization Name:THE ROSE HEARING GROUP , LLC
Other - Org Name:ROSE HEARING HEALTHCARE CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:HIS/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-845-2077
Mailing Address - Street 1:1505 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HILTON HEAD
Mailing Address - State:SC
Mailing Address - Zip Code:29926-1608
Mailing Address - Country:US
Mailing Address - Phone:843-547-5832
Mailing Address - Fax:
Practice Address - Street 1:1505 MAIN ST
Practice Address - Street 2:
Practice Address - City:HILTON HEAD
Practice Address - State:SC
Practice Address - Zip Code:29926-1608
Practice Address - Country:US
Practice Address - Phone:843-547-5832
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-31
Last Update Date:2018-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCHAS-0640237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty