Provider Demographics
NPI:1720186760
Name:ROVIN INC
Entity Type:Organization
Organization Name:ROVIN INC
Other - Org Name:VALLEY VISION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-522-9411
Mailing Address - Street 1:2819 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25702-1435
Mailing Address - Country:US
Mailing Address - Phone:304-522-9411
Mailing Address - Fax:304-522-4651
Practice Address - Street 1:2819 5TH AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25702-1435
Practice Address - Country:US
Practice Address - Phone:304-522-9411
Practice Address - Fax:304-522-4651
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2008-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332H00000XSuppliersEyewear Supplier
No156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0151333000Medicaid
WV001705378OtherBC/BS
WV001705378OtherBC/BS