Cosgrove, Emmett Dewayne
Cosgrove, Emmett Dewayne is an sole proprietor health care provider with primary practice located at 11282 M140 Highway , South Haven MI 49090-9405. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Cosgrove, Emmett Dewayne can be contacted via phone (269) 637-1569.Contact Information
Primary practice address
11282 M140 Highway
South Haven MI 49090-9405
Phone: (269) 637-1569
Fax: (269) 637-4519
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 002521 | Michigan |
Profile Details
| NPI number | 1316941255 |
|---|---|
| LBN Legal business name | Cosgrove, Emmett Dewayne |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 9th, 2005 |
| Last updated | Aug 18th, 2008 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1316941255 | NPPES |
| Other | 22-32002 | UNITED HEALTH CARE/PHP | |
| Other | 900H06501 | UNITED HEALTH CARE/PHP | |
| MEDICAID | 5098573 | UNITED HEALTH CARE/PHP |
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