MEDICARE: MR. ALBERT ANTHONY ROGERS III PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	PH232578	MA
2	183500000X	Pharmacist	R2246	NH

General Provider Information

NPI Number	:	1164024055
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ALBERT ANTHONY ROGERS III PHARMD

Provider Business Mailing Address
First Line	:	700 LAFAYETTE RD UNIT 1
Second Line	:
City	:	SEABROOK
State	:	NH
Zip	:	03874-6202
Country	:	US
Telephone Number	:	603-474-2514
Fax Number	:

Provider Business Practice Location Address
First Line	:	700 LAFAYETTE RD UNIT 1
Second Line	:
City	:	SEABROOK
State	:	NH
Zip	:	03874-6202
Country	:	US
Telephone Number	:	603-474-2514
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/15/2020
Last Update Date	:	11/15/2020

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