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NPI 1780974535

NPI 1780974535 : BRUCE ALAN RODGERS BS PHARMACY : DAYTON, OH

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General NPI Number Information
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    NPI Number           |    1780974535
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    Entity Type          |    Individual 
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    Provider Name        |    BRUCE ALAN RODGERS BS PHARMACY
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    04/13/2011
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    Last Update Date     |    04/13/2011
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Provider Practice Location Address
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    Address Line         |    2532 E 3RD ST 
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    City                 |    DAYTON
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    State                |    OH
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    Zip                  |    45403-2019
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    Country              |    US
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    Telephone            |    937-258-8101
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    Fax                  |    937-258-1468
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Provider Business Mailing Address
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    Address Line         |    2532 E 3RD ST 
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    City                 |    DAYTON
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    State                |    OH
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    Zip                  |    45403-2019
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    Country              |    US
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    Telephone            |    937-258-8101
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    Fax                  |    937-258-1468
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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       |    03213901
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    License Number State |    OH
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