Rose Optical, Inc.
NPI 1669444063ActiveOrganization· Optometrist· Godfrey, IL
Optometrist in Godfrey, Illinois, registered in NPPES in February 2006. The authorized official on file is Marie Annette Mangrum, Board Secretary/Treas. Enrolled in Medicare as dme supplier - optician and part b supplier - clinic/group practice.
Overview
| NPI | 1669444063 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Feb 2, 2006 |
| Last updated in NPPES | Aug 29, 2011 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Optometrist Primary | 152W00000X | 22652655 | IL |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled DME Supplier - Optician (IL); Part B Supplier - Clinic/Group Practice (IL) |
|---|
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