Healthcare Provider Details

I. General information

NPI: 1417187220
Provider Name (Legal Business Name): ROGERS HEARING HEALTHCARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2009
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

433 BROAD ST SUITE A
COLUMBIA MS
39429-3038
US

IV. Provider business mailing address

PO BOX 17167
HATTIESBURG MS
39404-7167
US

V. Phone/Fax

Practice location:
  • Phone: 601-736-4002
  • Fax:
Mailing address:
  • Phone: 601-261-5995
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License NumberA3163
License Number StateMS

VIII. Authorized Official

Name: MS. STACY M DUBOIS
Title or Position: INSURANCE MANAGER
Credential: BS, HIS
Phone: 601-261-5995