Healthcare Provider Details

I. General information

NPI: 1184635757
Provider Name (Legal Business Name): FARRELL PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2006
Last Update Date: 10/20/2025
Certification Date: 10/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

827 SHARON NEW CASTLE RD
FARRELL PA
16121-2413
US

IV. Provider business mailing address

30 CONNEAUT LAKE ROAD
GREENVILLE PA
16125-2167
US

V. Phone/Fax

Practice location:
  • Phone: 724-981-4553
  • Fax: 724-981-2993
Mailing address:
  • Phone: 724-612-2131
  • Fax: 724-981-2993

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPP410710L
License Number StatePA

VIII. Authorized Official

Name: BRETTON CLARK WALBERG
Title or Position: MEMBER
Credential: RPH
Phone: 724-612-2131