Provider Demographics
NPI:1326705260
Name:ROCHON, JACOB LOUIS
Entity Type:Individual
Prefix:
First Name:JACOB
Middle Name:LOUIS
Last Name:ROCHON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27743 BRIGGS HILL RD
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97405-9734
Mailing Address - Country:US
Mailing Address - Phone:541-852-0984
Mailing Address - Fax:
Practice Address - Street 1:145 E 18TH AVE
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-4107
Practice Address - Country:US
Practice Address - Phone:541-683-9684
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-28
Last Update Date:2021-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0018648183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist