Provider Demographics
NPI:1659593424
Name:OCHS, FREDERICK ANDREW JR (RPH)
Entity Type:Individual
Prefix:MR
First Name:FREDERICK
Middle Name:ANDREW
Last Name:OCHS
Suffix:JR
Gender:M
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:E4426 COUNTY ROAD D
Mailing Address - Street 2:
Mailing Address - City:MENOMONIE
Mailing Address - State:WI
Mailing Address - Zip Code:54751-5446
Mailing Address - Country:US
Mailing Address - Phone:715-235-0412
Mailing Address - Fax:
Practice Address - Street 1:1232 BROADWAY ST N
Practice Address - Street 2:
Practice Address - City:MENOMONIE
Practice Address - State:WI
Practice Address - Zip Code:54751-1517
Practice Address - Country:US
Practice Address - Phone:715-235-4235
Practice Address - Fax:715-235-1270
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7990-040183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI7990-040OtherPHARMACIST LICENSE