Healthcare Provider Details

I. General information

NPI: 1164833778
Provider Name (Legal Business Name): ROGERS AT HOME INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2014
Last Update Date: 05/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 EXECUTIVE PARK
LOUISVILLE KY
40207-4202
US

IV. Provider business mailing address

221 EXECUTIVE PARK
LOUISVILLE KY
40207-4202
US

V. Phone/Fax

Practice location:
  • Phone: 502-897-0580
  • Fax: 502-897-0581
Mailing address:
  • Phone: 502-897-0580
  • Fax: 502-897-0581

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: TERRY ROGERS
Title or Position: OWNER
Credential:
Phone: 502-897-0580