Healthcare Provider Details

I. General information

NPI: 1891985370
Provider Name (Legal Business Name): ROGERS HEARING HEALTHCARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2007
Last Update Date: 11/30/2023
Certification Date: 11/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1104 W 1ST ST STE 9
LAUREL MS
39440-4357
US

IV. Provider business mailing address

PO BOX 17167
HATTIESBURG MS
39404-7167
US

V. Phone/Fax

Practice location:
  • Phone: 601-426-9628
  • Fax:
Mailing address:
  • Phone: 601-261-5995
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License NumberA9340
License Number StateLA
# 2
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: BC-HIS
Phone: 601-261-5995