Healthcare Provider Details

I. General information

NPI: 1922911767
Provider Name (Legal Business Name): MICHELLE ELIZABETH FARRELL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

228 STRAWBRIDGE DR
MOORESTOWN NJ
08057-4600
US

IV. Provider business mailing address

6310 BOWEN RD
BENSALEM PA
19020-1202
US

V. Phone/Fax

Practice location:
  • Phone: 888-974-2763
  • Fax:
Mailing address:
  • Phone: 267-566-2608
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI04184800
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP456472
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: