Provider Demographics
NPI:1689045460
Name:RUSHMORE CROSSING VISION CENTER, LLC
Entity Type:Organization
Organization Name:RUSHMORE CROSSING VISION CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ROSS
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:ENGLISH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:605-342-1213
Mailing Address - Street 1:PO BOX 1333
Mailing Address - Street 2:
Mailing Address - City:SPEARFISH
Mailing Address - State:SD
Mailing Address - Zip Code:57783-7333
Mailing Address - Country:US
Mailing Address - Phone:605-342-1213
Mailing Address - Fax:605-342-1218
Practice Address - Street 1:925 EGLIN ST
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-9567
Practice Address - Country:US
Practice Address - Phone:605-342-1213
Practice Address - Fax:605-342-1218
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-19
Last Update Date:2015-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD707152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty