Provider Demographics
NPI:1659846798
Name:ARCHER-ROSE, LLC
Entity Type:Organization
Organization Name:ARCHER-ROSE, LLC
Other - Org Name:KERRVILLE MEDICAL EQUIPMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CASEY
Authorized Official - Middle Name:SLAY
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:830-990-4775
Mailing Address - Street 1:1408 E MAIN ST STE 200
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78624-5376
Mailing Address - Country:US
Mailing Address - Phone:830-990-4775
Mailing Address - Fax:830-990-7597
Practice Address - Street 1:1404 SIDNEY BAKER ST
Practice Address - Street 2:
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028-2725
Practice Address - Country:US
Practice Address - Phone:830-990-4775
Practice Address - Fax:830-990-7597
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-04
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies