Provider Demographics
NPI:1730495631
Name:ROGERS, DEBRA MCCOY (RPH)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:MCCOY
Last Name:ROGERS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8703 HIGDON DR
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-2312
Mailing Address - Country:US
Mailing Address - Phone:703-281-1899
Mailing Address - Fax:
Practice Address - Street 1:8703 HIGDON DR
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-2312
Practice Address - Country:US
Practice Address - Phone:703-281-1899
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-30
Last Update Date:2010-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202005759183500000X
MD095531835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist