Healthcare Provider Details

I. General information

NPI: 1568346096
Provider Name (Legal Business Name): PAMELA LASHIA ROGERS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2025
Last Update Date: 10/27/2025
Certification Date: 10/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 COURT ST
EVERGREEN AL
36401-2847
US

IV. Provider business mailing address

222 ELIZABETH ST
EVERGREEN AL
36401-2506
US

V. Phone/Fax

Practice location:
  • Phone: 251-227-2445
  • Fax:
Mailing address:
  • Phone: 251-227-2445
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: