| Bogerosa Inc. | |
|
602 Ash Avenue, Glen Ullin, ND 58632-0065 | |
| (701) 348-9175 | |
| Not Available |
| Full Name | Bogerosa Inc. |
|---|---|
| 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 |
|---|---|
| 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 |
|---|---|
| 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 |