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General NPI Number Information
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NPI Number | 1609667583
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Entity Type | Individual
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Provider Name | ANDREA CALLOWAY ROGERS
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Gender | Female
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Dates
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Enumeration Date | 05/13/2025
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Last Update Date | 05/13/2025
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Provider Practice Location Address
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Address Line | 812 W KING ST
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City | KINGS MOUNTAIN
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State | NC
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Zip | 28086-2748
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Country | US
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Telephone | 704-739-5456
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Fax |
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Provider Business Mailing Address
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Address Line | 200 E 2ND AVE
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City | GASTONIA
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State | NC
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Zip | 28052-4358
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Country | US
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Telephone | 704-685-2951
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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 | 09658
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License Number State | NC
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