MEDICARE: MR. MICHAEL EDWARD FARRELL R.PH.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	9083	KY

General Provider Information

NPI Number	:	1437364452
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MICHAEL EDWARD FARRELL R.PH.

Provider Business Mailing Address
First Line	:	524 GARRARD ST APT 3
Second Line	:
City	:	COVINGTON
State	:	KY
Zip	:	41011-4206
Country	:	US
Telephone Number	:	859-431-5561
Fax Number	:

Provider Business Practice Location Address
First Line	:	301 ELM ST
Second Line	:
City	:	LUDLOW
State	:	KY
Zip	:	41016-1450
Country	:	US
Telephone Number	:	859-261-2210
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/12/2007
Last Update Date	:	07/08/2007

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