Provider Demographics
NPI:1942323084
Name:ROSA OF THE SOUTH PLAINS, LLP
Entity Type:Organization
Organization Name:ROSA OF THE SOUTH PLAINS, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:S
Authorized Official - Last Name:MERRILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-250-1783
Mailing Address - Street 1:320 SEVEN SPRINGS WAY
Mailing Address - Street 2:SUITE 250
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-4537
Mailing Address - Country:US
Mailing Address - Phone:615-250-1798
Mailing Address - Fax:615-250-1644
Practice Address - Street 1:4002 21ST ST
Practice Address - Street 2:SUITE A
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79410-1135
Practice Address - Country:US
Practice Address - Phone:806-793-1406
Practice Address - Fax:806-706-1167
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty