Provider Demographics
NPI:1558663997
Name:ROGERS, DAVID ANDREW (RPH)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:ANDREW
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 1:745 E SOUTH BOULDER RD APT C113
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80027-2520
Mailing Address - Country:US
Mailing Address - Phone:130-399-4617
Mailing Address - Fax:303-843-7824
Practice Address - Street 1:1375 S BOULDER RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027-2344
Practice Address - Country:US
Practice Address - Phone:303-303-6731
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-17
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO13821183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist