Provider Demographics
NPI:1679856934
Name:OHM, ANDREW JR (BSPHARMACY)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:
Last Name:OHM
Suffix:JR
Gender:M
Credentials:BSPHARMACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 W 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:PA
Mailing Address - Zip Code:15120-1008
Mailing Address - Country:US
Mailing Address - Phone:412-461-9782
Mailing Address - Fax:412-461-6853
Practice Address - Street 1:133 W 8TH AVE
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:PA
Practice Address - Zip Code:15120
Practice Address - Country:US
Practice Address - Phone:412-461-9782
Practice Address - Fax:412-461-9853
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-23
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP035441L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist