Provider Demographics
NPI:1619595253
Name:OCHIENG, TAMEKA A (RPH)
Entity type:Individual
Prefix:MRS
First Name:TAMEKA
Middle Name:A
Last Name:OCHIENG
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MS
Other - First Name:TAMEKA
Other - Middle Name:A
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:1889 FOREST VIEW CT
Mailing Address - Street 2:
Mailing Address - City:COMMERCE TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48390-3931
Mailing Address - Country:US
Mailing Address - Phone:904-891-9424
Mailing Address - Fax:
Practice Address - Street 1:29030 NORTHWESTERN HWY
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-1010
Practice Address - Country:US
Practice Address - Phone:248-356-1757
Practice Address - Fax:248-356-1857
Is Sole Proprietor?:No
Enumeration Date:2020-07-09
Last Update Date:2020-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS54437183500000X
MI5302046292183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist