Healthcare Provider Details

I. General information

NPI: 1720114515
Provider Name (Legal Business Name): W. OWEN ROGERS R.PH.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: WILLIAM OWEN ROGERS R.PH.

II. Dates (important events)

Enumeration Date: 02/26/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3185 W APACHE TRL
APACHE JUNCTION AZ
85220-3687
US

IV. Provider business mailing address

9611 E MONTEREY AVE
MESA AZ
85209-2248
US

V. Phone/Fax

Practice location:
  • Phone: 480-288-2728
  • Fax: 480-288-2730
Mailing address:
  • Phone: 480-354-1605
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number7699
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: