MEDICARE: JULIANNA G ROGERS PHC

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	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	PC00000250	NM

General Provider Information

NPI Number	:	1538516034
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIANNA G ROGERS PHC

Provider Business Mailing Address
First Line	:	1131 UNIVERSITY BLVD NE
Second Line	:	SUITE G
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87102-1728
Country	:	US
Telephone Number	:	505-272-2341
Fax Number	:	505-272-8177

Provider Business Practice Location Address
First Line	:	1131 UNIVERSITY BLVD NE
Second Line	:	SUITE G
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87102-1728
Country	:	US
Telephone Number	:	505-272-2341
Fax Number	:	505-272-8177

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

Provider Enumeration Date	:	05/16/2016
Last Update Date	:	06/15/2023

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