Provider Demographics
NPI:1275257099
Name:ROGGE, DUSTIN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DUSTIN
Middle Name:
Last Name:ROGGE
Suffix:
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 1:227 C ST
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:KS
Mailing Address - Zip Code:66968-1906
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:227 C ST
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:KS
Practice Address - Zip Code:66968-1906
Practice Address - Country:US
Practice Address - Phone:785-325-3130
Practice Address - Fax:785-325-3260
Is Sole Proprietor?:No
Enumeration Date:2022-09-27
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-14157183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist