Provider Demographics
NPI:1821063306
Name:THE ROSE GROUP, INC
Entity Type:Organization
Organization Name:THE ROSE GROUP, INC
Other - Org Name:SUWANNEE MEDICAL PERSONNEL/SUWANNEE HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FRED
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-755-1544
Mailing Address - Street 1:817 NW 56TH TER
Mailing Address - Street 2:SUITEA
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-6418
Mailing Address - Country:US
Mailing Address - Phone:386-496-3034
Mailing Address - Fax:386-496-1034
Practice Address - Street 1:1852 SW BARNETT WAY
Practice Address - Street 2:SUITE 103
Practice Address - City:LAKE CITY
Practice Address - State:FL
Practice Address - Zip Code:32025
Practice Address - Country:US
Practice Address - Phone:386-755-1544
Practice Address - Fax:386-758-7828
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE ROSE GROUP, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-02-20
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL216090961251E00000X
FL299991861251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL673933400Medicaid
FL678777165Medicaid
FL689667779Medicaid
FL650989500Medicaid
FL650989479Medicaid
FL677148396Medicaid
FL650900200Medicaid
FL650900201Medicaid
FL676709500Medicaid
FL108010Medicare PIN
FL673933400Medicaid
FL108010Medicare Oscar/Certification