| Organization Name: | ROSE MEDICAL GROUPS, PC |
| NPI Number: | 1124426358 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARIA L SULLIVAN (CHIEF EXECUTIVE OFFICER) |
| Mailing Address: | 18 Nw 20th Ave Suite 101 Battle Ground |
| State: | WA US |
| Postal Code: | 986044226 |
| Phone Number: | 3609524457 |
| Fax Number: | 3609497888 |
| NPI Enumeration Date: | 12/22/2014 |
| NPI Last Update Date: | 02/25/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QU0200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Urgent Care |
| Taxonomy Definition: | |