| Rose Optical, Inc. | |
|
3300 Godfrey Rd, Godfrey, IL 62035-2558 | |
| (618) 466-8787 | |
| (618) 466-4703 |
| Full Name | Rose Optical, Inc. |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 3300 Godfrey Rd, Godfrey, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669444063 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | 22652655 (Illinois) | Primary |
| Provider Name | Mark E Ferguson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1598897456 PECOS PAC ID: 3779667613 Enrollment ID: I20080229000688 |
| Provider Name | Bradley D Martinson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1174774079 PECOS PAC ID: 5193886273 Enrollment ID: I20081208000391 |
| Provider Name | Holly R Klein |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1407086945 PECOS PAC ID: 6305960915 Enrollment ID: I20101222000299 |
| Provider Name | Keith Lyston |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1861614810 PECOS PAC ID: 3476648296 Enrollment ID: I20200210000154 |
| Mailing Address | Practice Location Address |
|---|---|
| Rose Optical, Inc. Po Box 5040, Godfrey, IL 62035-5040 Ph: (618) 466-8787 | Rose Optical, Inc. 3300 Godfrey Rd, Godfrey, IL 62035-2558 Ph: (618) 466-8787 |
Bradley D Martinson, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 3300 Godfrey Rd, Godfrey, IL 62035 Phone: 618-466-8787 Fax: 618-466-4703 | |
Adeyinka A Adewale, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 3300 Godfrey Rd, Godfrey, IL 62035 Phone: 618-466-8787 Fax: 618-466-4703 | |
Dr. Mark Edward Ferguson, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 3300 Godfrey Rd, Godfrey, IL 62035 Phone: 618-466-8787 Fax: 618-466-4703 | |
Andrew Ibisch, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 1310 Dadrian Prof Park, Godfrey, IL 62035 Phone: 618-433-5005 Fax: 618-467-1053 | |
Ron Loflin, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 3300 Godfrey Rd, Godfrey, IL 62035 Phone: 618-466-8787 | |
Illini Optometric Pc Optometrist Medicare: Not Enrolled in Medicare Practice Location: 3300 Godfrey Rd, Godfrey, IL 62035 Phone: 618-466-8787 Fax: 618-466-4703 |