Rosedale Eyecare Llc

LBN: Rosedale Eyecare
Rosedale Eyecare Llc is an health care organization with primary practice located at 19460 Grand River , Detroit MI 48223. The organization recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Suppliers / Eyewear Supplier (Equipment, not the service). Eye and Vision Services Providers / Optometrist is the primary health care specialty. Rosedale Eyecare can be contacted via phone (313) 533-4003, or through Martin, Derrick Ray via phone (313) 533-4003.

Contact Information

Primary practice address
19460 Grand River Detroit MI 48223
Phone: (313) 533-4003
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Martin, Derrick Ray
Phone: (313) 533-4003

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X
Suppliers / Eyewear Supplier (Equipment, not the service) 332H00000X 4901002131 Michigan

Profile Details

NPI number 1902968837
LBN Legal business name Rosedale Eyecare
DBA Doing business as Rosedale Eyecare Llc
Authorized official Martin, Derrick Ray
Entity Organization
Organization subpart 1 No
Enumeration date Dec 15th, 2006
Last updated Aug 22nd, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902968837 NPPES
Michigan MEDICAID 4J10880

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