MEDICARE: CAROL SCHOGER

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	163W00000X	Registered Nurse	078040271RN	OR

General Provider Information

NPI Number	:	1891212148
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROL SCHOGER

Provider Business Mailing Address
First Line	:	3617 S PACIFIC HWY
Second Line	:
City	:	MEDFORD
State	:	OR
Zip	:	97501-8957
Country	:	US
Telephone Number	:	541-535-6239
Fax Number	:

Provider Business Practice Location Address
First Line	:	806 6TH AVE N
Second Line	:
City	:	GOLD HILL
State	:	OR
Zip	:	97525-9762
Country	:	US
Telephone Number	:	541-494-6800
Fax Number	:

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

Provider Enumeration Date	:	08/28/2017
Last Update Date	:	08/28/2017

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