Provider Demographics
NPI:1164024055
Name:ROGERS, ALBERT ANTHONY III (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:ALBERT
Middle Name:ANTHONY
Last Name:ROGERS
Suffix:III
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 LAFAYETTE RD UNIT 1
Mailing Address - Street 2:
Mailing Address - City:SEABROOK
Mailing Address - State:NH
Mailing Address - Zip Code:03874-6202
Mailing Address - Country:US
Mailing Address - Phone:603-474-2514
Mailing Address - Fax:
Practice Address - Street 1:700 LAFAYETTE RD UNIT 1
Practice Address - Street 2:
Practice Address - City:SEABROOK
Practice Address - State:NH
Practice Address - Zip Code:03874-6202
Practice Address - Country:US
Practice Address - Phone:603-474-2514
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-15
Last Update Date:2020-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH232578183500000X
NHR2246183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist