MEDICARE: MRS. JULIE MARIE RODGERS PHARM.D

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	1835P1200X	Pharmacotherapy Pharmacist	15999	NV

General Provider Information

NPI Number	:	1427015387
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JULIE MARIE RODGERS PHARM.D

Provider Business Mailing Address
First Line	:	PO BOX 360001
Second Line	:	(08-119)
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89036-8108
Country	:	US
Telephone Number	:	702-636-3000
Fax Number	:	702-636-6336

Provider Business Practice Location Address
First Line	:	3131 LA CANADA ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89169-2578
Country	:	US
Telephone Number	:	702-636-3000
Fax Number	:	702-636-6306

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

Provider Enumeration Date	:	04/26/2006
Last Update Date	:	09/04/2009

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