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General NPI Number Information
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NPI Number | 1508064239
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Entity Type | Individual
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Provider Name | BRYAN M RODGERS PHARM.D.
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Gender | Male
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Dates
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Enumeration Date | 07/03/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 467 N DIXIE BLVD
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City | RADCLIFF
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State | KY
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Zip | 40160-1306
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Country | US
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Telephone | 270-351-3313
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Fax |
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Provider Business Mailing Address
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Address Line | 113 TALLYHO WAY
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City | ELIZABETHTOWN
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State | KY
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Zip | 42701-7829
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Country | US
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Telephone | 270-982-1285
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 013668
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License Number State | KY
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