Healthcare Provider Details

I. General information

NPI: 1831005685
Provider Name (Legal Business Name): ROGUE COMMUNITY HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 CENTRAL AVE
ASHLAND OR
97520-1787
US

IV. Provider business mailing address

1221 DISK DR
MEDFORD OR
97501-6638
US

V. Phone/Fax

Practice location:
  • Phone: 541-773-3863
  • Fax: 541-842-7637
Mailing address:
  • Phone: 541-773-3863
  • Fax: 541-842-7637

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: AMY CERVAN
Title or Position: SR. DIRECTOR OF PHARMACY
Credential:
Phone: 541-200-6859