Provider Demographics
NPI:1215420880
Name:RODGERS, WILLIAM (RPH)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:RODGERS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:BILL
Other - Middle Name:
Other - Last Name:RODGERS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RPH
Mailing Address - Street 1:253 HIDDEN VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:42743-1465
Mailing Address - Country:US
Mailing Address - Phone:270-789-8337
Mailing Address - Fax:270-932-3249
Practice Address - Street 1:253 HIDDEN VALLEY RD
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:KY
Practice Address - Zip Code:42743-1465
Practice Address - Country:US
Practice Address - Phone:270-789-8337
Practice Address - Fax:270-932-3249
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-08
Last Update Date:2018-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY007853183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist