Organization
JOHN DAVID ROGERS
Active
Other names
Kinetic Health Care
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN D ROGERS (OWNER)
(304) 926-0870
Entity
Organization
Contact information
Practice address
2200 GRAND CENTRAL AVE, SUITE 105, VIENNA, WV 26105-1300
(304) 295-6041
(304) 295-6182
Mailing address
PO BOX 638, RIPLEY, WV 25271-0638
(304) 926-0870
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001815473
BLUE CROSS BLUE SHIELD
WV
05
—
0147774001
—
WV
05
—
2027096
—
OH
Enumeration date
11/02/2006
Last updated
07/21/2022
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