NPIMap

Organization Active NPI

Rogers Pharmacy #4

  • Community/Retail Pharmacy
  • Victoria, TX
National Provider Identifier
1356482996
Registry record updated May 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
17588 Issued in TX
Legal business name
ROGERS PHARMACY #4
Practice address
6502 Nursery Dr
Suite 102
Victoria, TX 77904-1178
Phone
(361) 572-0226
NPI assigned
Feb 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Bruce Wilson Rogers
Title
Owner
Phone
(361) 576-6599

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 17588 TX Primary

Addresses

Primary practice location

6502 Nursery Dr
Suite 102
Victoria, TX 77904-1178

Mailing address

PO Box 3670
Victoria, TX 77903-3670
Phone (361) 576-6599

Other identifiers 2

IdentifierTypeStateIssuer
4599683OtherTXNABP
144586MedicaidTX

National Provider Directory

National Provider Directory
Tax ID family
Rogers Pharmacy 56 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

6502 Nursery Dr
Ste 102
Victoria, TX 77904
Phone (361) 572-0226

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746403200000",
    "number": "1356482996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3670",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779033670",
            "telephone_number": "361-576-6599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6502 NURSERY DR",
            "address_2": "SUITE 102",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779041178",
            "telephone_number": "361-572-0226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROGERS PHARMACY #4",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-08",
        "last_updated": "2025-05-05",
        "certification_date": "2025-05-05",
        "status": "A",
        "authorized_official_last_name": "ROGERS",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "WILSON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "361-576-6599"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "17588",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP",
            "identifier": "4599683",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "144586",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Victoria, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.