Provider Demographics
NPI:1053745224
Name:BOCKHORN, SARA (RPH)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:BOCKHORN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 TURTLE CREEK DR
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:45140-7924
Mailing Address - Country:US
Mailing Address - Phone:513-405-4864
Mailing Address - Fax:
Practice Address - Street 1:324 TURTLE CREEK DR
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:OH
Practice Address - Zip Code:45140-7924
Practice Address - Country:US
Practice Address - Phone:513-405-4864
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-23
Last Update Date:2013-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03124305183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist