Provider Demographics
NPI:1386776169
Name:ROSS & BIRGE INC
Entity type:Organization
Organization Name:ROSS & BIRGE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:K
Authorized Official - Last Name:BIRGE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:270-487-5741
Mailing Address - Street 1:22 EXECUTIVE DR
Mailing Address - Street 2:
Mailing Address - City:TOMPKINSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42167-7478
Mailing Address - Country:US
Mailing Address - Phone:270-487-5741
Mailing Address - Fax:270-487-9664
Practice Address - Street 1:22 EXECUTIVE DR
Practice Address - Street 2:
Practice Address - City:TOMPKINSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42167-7478
Practice Address - Country:US
Practice Address - Phone:270-487-5741
Practice Address - Fax:270-487-9664
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2010-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1386776169OtherMEDICARE GROUP NPI
KY1720086267OtherNPI NUMBERS
KY77000933Medicaid
KY5940OtherDAVIS VISION
KY1205834587OtherNPI NUMBERS
KY1801894340OtherNPI NUMBERS
KY77011013Medicaid
KY410049286OtherRAILROAD MEDICARE
KY77007557Medicaid
KY1386776169OtherMEDICAID GROUP NPI
KY03322OtherSPECTERA
KY1720086267OtherNPI NUMBERS
KY1801894340OtherNPI NUMBERS