Provider Demographics
NPI:1376264713
Name:OCHS, ROBERTA LYNN
Entity Type:Individual
Prefix:
First Name:ROBERTA
Middle Name:LYNN
Last Name:OCHS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 ELMCROFT CT APT D105
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-5861
Mailing Address - Country:US
Mailing Address - Phone:605-521-7678
Mailing Address - Fax:
Practice Address - Street 1:21 ELMCROFT CT APT D105
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-5861
Practice Address - Country:US
Practice Address - Phone:605-521-7678
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-05
Last Update Date:2022-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD3336I0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336I0012XSuppliersPharmacyInstitutional Pharmacy