Provider Demographics
NPI:1063878155
Name:OCJ INC
Entity type:Organization
Organization Name:OCJ INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:JUDE
Authorized Official - Middle Name:
Authorized Official - Last Name:OBIAKOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-401-8455
Mailing Address - Street 1:3581 DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48601-4204
Mailing Address - Country:US
Mailing Address - Phone:989-401-8455
Mailing Address - Fax:989-401-8456
Practice Address - Street 1:3581 DIXIE HWY
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48601-4204
Practice Address - Country:US
Practice Address - Phone:989-401-8455
Practice Address - Fax:989-401-8456
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-06
Last Update Date:2017-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
MI53010107723336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1063878155Medicaid
2156082OtherPK