MEDICARE: STEVE PAUL RODGER RPH

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	1791	WY

General Provider Information

NPI Number	:	1306936240
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEVE PAUL RODGER RPH

Provider Business Mailing Address
First Line	:	2317 MAIN ST
Second Line	:
City	:	TORRINGTON
State	:	WY
Zip	:	82240-2319
Country	:	US
Telephone Number	:	307-532-2857
Fax Number	:

Provider Business Practice Location Address
First Line	:	2041 MAIN ST
Second Line	:
City	:	TORRINGTON
State	:	WY
Zip	:	82240-2708
Country	:	US
Telephone Number	:	307-532-2530
Fax Number	:	307-532-7136

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

Provider Enumeration Date	:	10/13/2006
Last Update Date	:	07/08/2007

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