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NPI Code Detail

MEDICARE: DR. EARL M. ROGERS I M.S., P.D.

MEDICARE: DR. EARL M. ROGERS I M.S., P.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
1183500000XPharmacist6783VA

General Provider Information

NPI Number : 1780684480
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. EARL M. ROGERS I M.S., P.D.
Provider Business Mailing Address
First Line : 11524 STILLBROOK RD
Second Line :
City : RICHMOND
State : VA
Zip : 23236-2408
Country : US
Telephone Number : 804-794-9541
Fax Number : 804-675-5762
Provider Business Practice Location Address
First Line : 1201 BROAD ROCK BLVD
Second Line : VAMC PHARMACY SVC (119)
City : RICHMOND
State : VA
Zip : 23249-0001
Country : US
Telephone Number : 804-675-5811
Fax Number : 804-675-5762
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2005
Last Update Date : 07/08/2007

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