Healthcare Provider Details

I. General information

NPI: 1265527006
Provider Name (Legal Business Name): CHARMAINE D. ROCHESTER :PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 NORTH GREENE STREET BALTIMORE VETERANS AFFAIRS
BALTIMORE MD
21201
US

IV. Provider business mailing address

4520 RUNNYMEADE RD
OWINGS MILLS MD
21117-6156
US

V. Phone/Fax

Practice location:
  • Phone: 410-605-7000
  • Fax: 410-605-7852
Mailing address:
  • Phone: 601-363-7624
  • Fax: 410-706-4725

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number17352
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: