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General NPI Number Information
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NPI Number | 1013998079
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Entity Type | Organization
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Legal Business Name | FARRELL AQUISITION CORPORATION
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Dates
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Enumeration Date | 11/08/2005
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Last Update Date | 10/15/2008
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Provider Practice Location Address
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Address Line | 4386 STURBRIDGE DRIVE
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City | HARRISBURG
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State | PA
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Zip | 17110-3886
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Country | US
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Telephone | 717-652-4924
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Fax | 717-652-1015
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Provider Business Mailing Address
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Address Line | 4386 STURBRIDGE DRIVE
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City | HARRISBURG
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State | PA
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Zip | 17110-3668
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Country | US
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Telephone | 717-652-4924
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Fax | 717-652-1015
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Authorized Official
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Title or Position | PRESIDENT
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Name | ELENA R FARRELL
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Credential | DO
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Telephone | 717-652-4924
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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