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) 720-6210
Entity
Organization
Contact information
Practice address
222 KANAWHA BLVD E, CHARLESTON, WV 25301-2511
(304) 926-0870
(307) 926-0871
Mailing address
PO BOX 638, RIPLEY, WV 25271-0638
(304) 926-0870
(304) 926-0871
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001815468
BLUE CROSS BLUE SHIELD
WV
05
—
0147774000
—
WV
05
—
2027096
—
OH
01
—
611531800
DEPARTMENT OF LABOR
WV
05
—
90008525
—
KY
Enumeration date
10/28/2006
Last updated
07/21/2022
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