MEDICARE: DR. EARL M. ROGERS I M.S., P.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	6783	VA

General Provider Information

NPI Number	:	1780684480
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EARL M. ROGERS I M.S., P.D.

Provider Business Mailing Address
First Line	:	11524 STILLBROOK RD
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23236-2408
Country	:	US
Telephone Number	:	804-794-9541
Fax Number	:	804-675-5762

Provider Business Practice Location Address
First Line	:	1201 BROAD ROCK BLVD
Second Line	:	VAMC PHARMACY SVC (119)
City	:	RICHMOND
State	:	VA
Zip	:	23249-0001
Country	:	US
Telephone Number	:	804-675-5811
Fax Number	:	804-675-5762

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/26/2005
Last Update Date	:	07/08/2007

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