Provider Demographics
NPI:1194474429
Name:ROSE VISTA HOME CARE LLC
Entity type:Organization
Organization Name:ROSE VISTA HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:MOOSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-712-2345
Mailing Address - Street 1:2202 MELISSA LN APT 19
Mailing Address - Street 2:
Mailing Address - City:KINSTON
Mailing Address - State:NC
Mailing Address - Zip Code:28504-8804
Mailing Address - Country:US
Mailing Address - Phone:252-654-4337
Mailing Address - Fax:
Practice Address - Street 1:2202 MELISSA LN APT 19
Practice Address - Street 2:
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28504-8804
Practice Address - Country:US
Practice Address - Phone:252-654-4337
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-23
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No253Z00000XAgenciesIn Home Supportive Care