Healthcare Provider Details

I. General information

NPI: 1174883227
Provider Name (Legal Business Name): JAMES JASON FARLEY PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2012
Last Update Date: 05/23/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

US 23 & 35TH ST
CATLETTSBURG KY
41129
US

IV. Provider business mailing address

4099 BOY SCOUT RD
ASHLAND KY
41102-6690
US

V. Phone/Fax

Practice location:
  • Phone: 606-739-4432
  • Fax:
Mailing address:
  • Phone: 606-369-6289
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number015209
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: