MEDICARE: LAURA ROGERS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	101YP1600X	Pastoral Counselor
2	171WH0202X	Home Modifications Contractor
3	376K00000X	Nurse's Aide
4	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1932769833
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA ROGERS

Provider Business Mailing Address
First Line	:	924 N CHURCH ST
Second Line	:
City	:	UNION
State	:	SC
Zip	:	29379-1653
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	107 DUPREE FARM RD
Second Line	:
City	:	BUFFALO
State	:	SC
Zip	:	29321-2712
Country	:	US
Telephone Number	:	864-380-2819
Fax Number	:

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

Provider Enumeration Date	:	06/13/2019
Last Update Date	:	06/13/2019

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Directions to “ LAURA ROGERS ” Practice Location

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