Healthcare Provider Details

I. General information

NPI: 1720035447
Provider Name (Legal Business Name): M. ROGERS, INC. & SUBSIDIARY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2006
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 MAIN ST
TARKIO MO
64491-1544
US

IV. Provider business mailing address

411 MAIN ST
TARKIO MO
64491-1544
US

V. Phone/Fax

Practice location:
  • Phone: 660-736-5512
  • Fax: 660-736-4361
Mailing address:
  • Phone: 660-736-5512
  • Fax: 660-736-4361

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number003813
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number003813
License Number StateMO

VIII. Authorized Official

Name: MR. BENNE ROGERS
Title or Position: CFO
Credential:
Phone: 660-442-5694