Provider Demographics
NPI:1730313198
Name:THE ROSE CLINIC, APMC
Entity Type:Organization
Organization Name:THE ROSE CLINIC, APMC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHARINE
Authorized Official - Middle Name:JUDSON
Authorized Official - Last Name:ROSE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:504-400-5993
Mailing Address - Street 1:218 FRIEDRICHS AVE
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70005-4517
Mailing Address - Country:US
Mailing Address - Phone:504-400-5993
Mailing Address - Fax:504-833-1278
Practice Address - Street 1:2820 ATHANIA PKWY
Practice Address - Street 2:SUITE 6
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-5981
Practice Address - Country:US
Practice Address - Phone:504-400-5993
Practice Address - Fax:504-833-1278
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-13
Last Update Date:2016-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA201310207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty