Provider Demographics
NPI:1073614459
Name:FERREN, ROCHELLE RAE (RPH)
Entity Type:Individual
Prefix:
First Name:ROCHELLE
Middle Name:RAE
Last Name:FERREN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4922 MARTIN DR SE
Mailing Address - Street 2:
Mailing Address - City:EAST SPARTA
Mailing Address - State:OH
Mailing Address - Zip Code:44626-9315
Mailing Address - Country:US
Mailing Address - Phone:330-484-4931
Mailing Address - Fax:
Practice Address - Street 1:733 MARKET AVE S
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44702-2165
Practice Address - Country:US
Practice Address - Phone:330-489-4600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-3-19870183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist