Provider Demographics
NPI:1851638068
Name:ROCKWOOD CLINIC PS
Entity Type:Organization
Organization Name:ROCKWOOD CLINIC PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:PEOPLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-465-7585
Mailing Address - Street 1:4000 MERIDIAN BLVD
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-6325
Mailing Address - Country:US
Mailing Address - Phone:615-465-7585
Mailing Address - Fax:
Practice Address - Street 1:842 S COWLEY ST
Practice Address - Street 2:SUITE 2
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-1234
Practice Address - Country:US
Practice Address - Phone:509-747-8900
Practice Address - Fax:509-624-7784
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-08
Last Update Date:2013-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0356240006Medicare NSC