Bogerosa Inc. | |
602 Ash Avenue, Glen Ullin, ND 58632-0065 | |
(701) 348-9175 | |
Not Available |
Full Name | Bogerosa Inc. |
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Type | Facility |
Speciality | Physical Therapist |
Location | 602 Ash Avenue, Glen Ullin, North Dakota |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1043289895 | NPI | - | NPPES |
55000 | Medicaid | ND | |
24439 | Other | ND | BLUE CROSS/BLUE SHIELD OF |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | ND 534 (North Dakota) | Primary |
Provider Name | Mark W Bogert |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1235302878 PECOS PAC ID: 8123925765 Enrollment ID: I20031212000783 |
Mailing Address | Practice Location Address |
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Bogerosa Inc. 4729 Amberglow Dr, Bismarck, ND 58503-8846 Ph: (701) 426-7095 | Bogerosa Inc. 602 Ash Avenue, Glen Ullin, ND 58632-0065 Ph: (701) 348-9175 |
Mark William Bogert, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 602 Ash Ave, Glen Ullin, ND 58632 Phone: 701-348-9175 | |
Dr. Sara Farrell, PT, DPT, CLT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 604 E Ash Ave, Glen Ullin, ND 58631 Phone: 701-348-3107 |