Healthcare Provider Details

I. General information

NPI: 1891007365
Provider Name (Legal Business Name): JOHN FARRELL STEVEN RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2010
Last Update Date: 07/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4830 WILLIAM PENN HWY
EXPORT PA
15632-9262
US

IV. Provider business mailing address

3973 MURRY HIGHLANDS CIR
MURRYSVILLE PA
15668-1747
US

V. Phone/Fax

Practice location:
  • Phone: 724-327-8233
  • Fax:
Mailing address:
  • Phone: 724-733-1431
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP028660L
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
IdentifierRP028660L
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerPENNSYLVANIA PHARMACY STAE LICENSE NUMBER

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: