Healthcare Provider Details

I. General information

NPI: 1376264713
Provider Name (Legal Business Name): ROBERTA LYNN OCHS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/05/2022
Last Update Date: 09/05/2022
Certification Date: 09/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 ELMCROFT CT APT D105
ROCKVILLE MD
20850-5861
US

IV. Provider business mailing address

21 ELMCROFT CT APT D105
ROCKVILLE MD
20850-5861
US

V. Phone/Fax

Practice location:
  • Phone: 605-521-7678
  • Fax:
Mailing address:
  • Phone: 605-521-7678
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License Number
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: