MEDICARE: HOWARD HENRY JOCHUM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	9949	NE

General Provider Information

NPI Number	:	1053930693
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HOWARD HENRY JOCHUM

Provider Business Mailing Address
First Line	:	120 E 18TH ST
Second Line	:
City	:	FALLS CITY
State	:	NE
Zip	:	68355-2116
Country	:	US
Telephone Number	:	402-245-2029
Fax Number	:

Provider Business Practice Location Address
First Line	:	120 E 18TH ST
Second Line	:
City	:	FALLS CITY
State	:	NE
Zip	:	68355-2116
Country	:	US
Telephone Number	:	402-245-2029
Fax Number	:	402-245-2521

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/14/2020
Last Update Date	:	04/14/2020

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