Provider Demographics
NPI:1497510317
Name:ROGERS FAMILY HEALTHCARE LLC
Entity Type:Organization
Organization Name:ROGERS FAMILY HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DLYNN
Authorized Official - Middle Name:DANIELLE
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, FNP-C
Authorized Official - Phone:478-231-7293
Mailing Address - Street 1:3371 FAIR HAVEN RD
Mailing Address - Street 2:
Mailing Address - City:EASTMAN
Mailing Address - State:GA
Mailing Address - Zip Code:31023-8451
Mailing Address - Country:US
Mailing Address - Phone:478-231-7293
Mailing Address - Fax:
Practice Address - Street 1:3371 FAIR HAVEN RD
Practice Address - Street 2:
Practice Address - City:EASTMAN
Practice Address - State:GA
Practice Address - Zip Code:31023-8451
Practice Address - Country:US
Practice Address - Phone:478-231-7293
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-20
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care