Healthcare Provider Details

I. General information

NPI: 1053930693
Provider Name (Legal Business Name): HOWARD HENRY JOCHUM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2020
Last Update Date: 04/14/2020
Certification Date: 04/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 E 18TH ST
FALLS CITY NE
68355-2116
US

IV. Provider business mailing address

120 E 18TH ST
FALLS CITY NE
68355-2116
US

V. Phone/Fax

Practice location:
  • Phone: 402-245-2029
  • Fax: 402-245-2521
Mailing address:
  • Phone: 402-245-2029
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number9949
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: