MEDICARE: DR. ERIC LEE FARTHING JR. PHARMD

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	2017025928	MO

General Provider Information

NPI Number	:	1649932708
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERIC LEE FARTHING JR. PHARMD

Provider Business Mailing Address
First Line	:	8927 CHICKASAW DR
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63132-2311
Country	:	US
Telephone Number	:	573-281-5443
Fax Number	:

Provider Business Practice Location Address
First Line	:	3340 S GRAND BLVD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63118-1017
Country	:	US
Telephone Number	:	314-772-5722
Fax Number	:

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

Provider Enumeration Date	:	10/06/2021
Last Update Date	:	10/06/2021

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