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General NPI Number Information
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NPI Number | 1548864127
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Entity Type | Individual
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Provider Name | DAVID J ROCHE JR. PHARMD
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Gender | Male
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Dates
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Enumeration Date | 11/24/2020
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Last Update Date | 11/24/2020
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Provider Practice Location Address
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Address Line | 100D N MAIN ST
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City | CARVER
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State | MA
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Zip | 02330-1046
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Country | US
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Telephone | 508-866-7001
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Fax | 508-866-2948
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Provider Business Mailing Address
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Address Line | 1098 WEST ST APT 3
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City | WRENTHAM
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State | MA
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Zip | 02093-1782
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PH236746
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License Number State | MA
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