Organization
J LANCASTER ROSE JR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
J LANCASTER ROSE JR. (OPTOMETRIST/OWNER)
(931) 359-1467
Entity
Organization
Contact information
Practice address
435 CEDAR ST, LEWISBURG, TN 37091-3351
(931) 359-1467
Mailing address
435 CEDAR ST, LEWISBURG, TN 37091-3351
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0077625
BCBS
TN
05
—
3596313
—
TN
Enumeration date
04/02/2008
Last updated
04/02/2008
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