Charles Rogers

Individual provider Active NPI Case Manager/Care Coordinator · Raton, NM

NPI 1386972610 · NPPES record last updated Nov 24, 2009

Key facts

NPI
1386972610
Entity type
Individual (NPI type 1)
Primary specialty
Case Manager/Care Coordinator 171M00000X
Practice address
101 Letton Dr
Raton, NM 87740-4366
Phone
(575) 445-8568
Fax
(575) 445-0540
NPI assigned
Nov 24, 2009
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X NM Yes

Addresses

Primary practice location

101 Letton Dr
Raton, NM 87740-4366

Mailing address

101 Letton Dr
Raton, NM 87740-4366
Phone (575) 445-8568

Other identifiers

IdentifierTypeStateIssuer
71525564MedicaidNM

Other providers in Raton, NM

All providers in Raton, NM · Case Manager/Care Coordinator in New Mexico

Sources for this page

Verify at the official NPI Registry.