Provider Information for 1346219060
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ROGAN'S COUNTRY PHARMACY
Organization Subpart: NO
NPI: 1346219060
Last Updated: 2012-06-05
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||||||
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| NPI | 1346219060 | ||||||||||||||||
| Enumeration Date | 2006-03-15 | ||||||||||||||||
| NPI Type | NPI-2 Organization | ||||||||||||||||
| Status | Active | ||||||||||||||||
| Authorized Official Information | Name: Mr. DEAN L ROGAN Sr. RPh Title: Owner, Pharmacist Phone: 6183426737 | ||||||||||||||||
| Mailing Address | PO BOX 241 PULASKI, IL 62976-0241 United States Phone: 618-342-6737 | Fax:618-342-6241 | ||||||||||||||||
| Primary Practice Address | 201 E COMMERCIAL PULASKI, IL 62976 United States Phone: 618-342-6737 | Fax:618-342-6241 | ||||||||||||||||
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