Provider Demographics
NPI:1902185531
Name:OKOH, ORHWERAKPOJEMRE (PHARMD)
Entity Type:Individual
Prefix:
First Name:ORHWERAKPOJEMRE
Middle Name:
Last Name:OKOH
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:JEMRE
Other - Middle Name:
Other - Last Name:OKOH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:105 SW 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:MILTON FREEWATER
Mailing Address - State:OR
Mailing Address - Zip Code:97862-1373
Mailing Address - Country:US
Mailing Address - Phone:541-938-8778
Mailing Address - Fax:541-938-6072
Practice Address - Street 1:105 SW 2ND AVE
Practice Address - Street 2:
Practice Address - City:MILTON FREEWATER
Practice Address - State:OR
Practice Address - Zip Code:97862-1373
Practice Address - Country:US
Practice Address - Phone:541-938-8778
Practice Address - Fax:541-938-6072
Is Sole Proprietor?:No
Enumeration Date:2011-08-13
Last Update Date:2011-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR0012684183500000X
IDP6519183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist