Provider Demographics
NPI:1548561640
Name:RODGERS, JOSEPH W III (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:W
Last Name:RODGERS
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 1:1260 W REDONDO BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:GARDENA
Mailing Address - State:CA
Mailing Address - Zip Code:90247-3411
Mailing Address - Country:US
Mailing Address - Phone:310-767-7940
Mailing Address - Fax:310-767-1294
Practice Address - Street 1:1260 W REDONDO BEACH BLVD
Practice Address - Street 2:
Practice Address - City:GARDENA
Practice Address - State:CA
Practice Address - Zip Code:90247-3411
Practice Address - Country:US
Practice Address - Phone:310-767-7940
Practice Address - Fax:310-767-1294
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-05
Last Update Date:2010-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA57809183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist