MEDICARE: ROGERS ROUTE LLC

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	343900000X	Non-emergency Medical Transport (VAN)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174109441
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROGERS ROUTE LLC

Provider Business Mailing Address
First Line	:	3317 N DIXIE DR
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45414-5678
Country	:	US
Telephone Number	:	513-968-9903
Fax Number	:

Provider Business Practice Location Address
First Line	:	7000 CENTRAL PKWY STE 1100
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30328-4592
Country	:	US
Telephone Number	:	678-571-8174
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	BRYON J ROGERS
Credential	:
Telephone Number	:	513-968-9903

Provider Enumeration Date	:	03/18/2021
Last Update Date	:	07/05/2022

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Directions to “ROGERS ROUTE LLC ” Practice Location

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