ROSE OSTEOPATHIC CLINIC, INC. (NPI# 1518902881) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1518902881 |
Entity Type | Organization |
Organization Name | ROSE OSTEOPATHIC CLINIC, INC. |
Other Organization Name | DEFRESE OSTEOPATHIC CLINIC, INC. |
Practice Address |
54699 Hillside Rd St Ignatius MT 59865-8915 |
Practice Telephone | 4067450845 |
Practice Fax Number | 4062043238 |
Mailing Telephone | 4067450845 |
Mailing Fax Number | 4062043238 |
Enumeration Date | 2006-06-19 |
Last Update Date | 2020-08-20 |
Authorized Official Name | DHARMA ROSE (PRESIDENT) |
Authorized Official Telephone | 4067450845 |
Authorized Official Credential | D.O. |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 261QH0100X |
Clinic/Center Specialization: Health Service |
02001899 | IN | Ambulatory Health Care Facilities |
Y | 261QH0100X |
Clinic/Center Specialization: Health Service |
MED-PHYS-LIC-534 | MT | Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
BCBS MONTANA PROVIDER IDENTIFIER | 1518902881 | 01 | |
IN | 200977140A | 05 | |
MT | 1902842883 | 05 |
Other Name | Type Code |
---|---|
Defrese Osteopathic Clinic, Inc. | Former Legal Business Name - Organization |
Address | Telephone Number | Fax Number |
---|---|---|
7500 Hoover Rd, Indianapolis, IN 462603544 | 3172548187 | |
9506 Hadway Dr, Indianapolis, IN 462561035 | 4067450845 | 4062043238 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1619447109 | Rose Osteopathic Clinic, Inc. | Pharmacy | 54699 Hillside Rd, St Ignatius, MT 59865-8915 | 2018-11-28 |
Street Address |
54699 HILLSIDE RD |
City | ST IGNATIUS |
State | MT |
Zip Code | 59865-8915 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1619447109 | Rose Osteopathic Clinic, Inc. | Pharmacy | 54699 Hillside Rd, St Ignatius, MT 59865-8915 | 2018-11-28 |
1902842883 | Dharma Rose | Neuromusculoskeletal Medicine & OMM | 54699 Hillside Rd, St Ignatius, MT 59865-8915 | 2006-06-21 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1366007544 | Donald Paul Roberts | Counselor | 109 First Avenue, St. Ignatius, MT 59865 | 2019-05-03 |
1518521657 | Maria Grieco | Social Worker | 76 3rd Ave, St. Ignatius, MT 59865 | 2019-04-24 |
1801363239 | Julie A. Cross | Dental Hygienist | 1 Woodscocks Way, St. Ignatius, MT 59865 | 2018-10-24 |
1346727468 | Shawn Michael Griffith | Dentist | 1 Woodcocks Way, St. Ignatius, MT 59865 | 2018-07-21 |
1063868743 | Natasha R. Sinclair | Registered Nurse | 308 Mission Dr., St. Ignatius, MT 59865 | 2016-05-11 |
1487067880 | Brenda Ferril | Chiropractor | 200 Mountain View St, St Ignatius, MT 59865 | 2014-06-04 |
1114248648 | Suzanne T Cannady | Pharmacist | #5 4th Ave E, Polson, MT 59865 | 2010-06-18 |
1083947055 | Sunburst Community Service Foundation, Inc | Clinic/Center | 109 1st Avenue, St Ignatius, MT 59865 | 2009-09-09 |
1396974572 | Jennifer Van Wagoner | Dentist | 35401 Mission Dr, St. Ignatius, MT 59865 | 2009-07-08 |
1124211297 | Gordon F Duff Gerrish | Psychologist | 56850 Fish Hatchery Road, St Ignatius, MT 59865 | 2007-08-22 |
Find all providers in zip 59865 |
Taxonomy Code | 261QH0100X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Health Service |
Definition to come... |
Notes: [7/1/2006: modified title] |
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City | ST IGNATIUS |
Zip Code | 59865 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.