Provider Demographics
NPI:1932272051
Name:ROGERS, ROBERT ANDERSON (RPH)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:ANDERSON
Last Name:ROGERS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 595
Mailing Address - Street 2:
Mailing Address - City:DARIEN
Mailing Address - State:GA
Mailing Address - Zip Code:31305-0595
Mailing Address - Country:US
Mailing Address - Phone:912-437-4066
Mailing Address - Fax:
Practice Address - Street 1:5 RIDGEWAY RD
Practice Address - Street 2:
Practice Address - City:DARIEN
Practice Address - State:GA
Practice Address - Zip Code:31305-9504
Practice Address - Country:US
Practice Address - Phone:912-437-4066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA011226183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist