Organization
ROGERS PHARMACY #4
Active
Organization
ROGERS PHARMACY #4
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRUCE WILSON ROGERS (OWNER)
(361) 576-6599
Entity
Organization
Contact information
Practice address
6502 NURSERY DR, SUITE 102, VICTORIA, TX 77904-1178
(361) 572-0226
Mailing address
PO BOX 3670, VICTORIA, TX 77903-3670
(361) 576-6599
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
17588
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
144586
—
TX
01
—
4599683
NABP
TX
Enumeration date
02/08/2007
Last updated
05/05/2025
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