MYS-ROSCOE LLC – NPI #1073340766
Clinic/Center

MYS-ROSCOE LLC is an AHC clinic located in ROSCOE, IL. NPPES has assigned the NPI number 1073340766 to MYS-ROSCOE LLC on September 17, 2024. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QD0000X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Dental

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for MYS-ROSCOE LLC below.

NPI Profile for
MYS-ROSCOE LLC

NPI Number
1073340766
Enumeration Date

(about 2 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
MYS-ROSCOE LLC
Primary location
5416 REIMER DRIVE
ROSCOE, IL 61073
Phone: (815) 398-3879 Fax:
Mailing address
1110 S MULFORD RD
ROCKFORD, IL 61108-4213
Phone: (815) 988-1993 Fax:
Organization Subpart
No
Authorized Official
TODD STERN
OWNER
Phone: (815) 398-3879
Updated
Certification Date
Sep 10, 2024

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QD0000X
- Clinic/Center / Dental (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.