Provider Demographics
NPI:1356225155
Name:ROGERS DRUG STORE
Entity type:Organization
Organization Name:ROGERS DRUG STORE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BINESHWAR
Authorized Official - Middle Name:BEN
Authorized Official - Last Name:PRASAD
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:209-522-5229
Mailing Address - Street 1:402 H ST
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95351-3308
Mailing Address - Country:US
Mailing Address - Phone:209-522-5229
Mailing Address - Fax:
Practice Address - Street 1:402 H ST
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95351-3308
Practice Address - Country:US
Practice Address - Phone:209-522-5229
Practice Address - Fax:209-522-8739
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ROGERS DRUG STORE INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-08-04
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy