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General NPI Number Information
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NPI Number | 1073265005
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Entity Type | Organization
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Legal Business Name | FARAH PHARMACY LLC
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Dates
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Enumeration Date | 01/20/2022
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Last Update Date | 02/22/2022
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Provider Practice Location Address
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Address Line | 465 BOULEVARD SE STE 111A
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City | ATLANTA
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State | GA
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Zip | 30312-3482
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Country | US
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Telephone | 832-818-8187
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Fax |
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Provider Business Mailing Address
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Address Line | 2554 LAKEVIEW EAST CT SE
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City | ATLANTA
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State | GA
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Zip | 30316-3440
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Country | US
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Telephone | 832-818-8187
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Fax |
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Authorized Official
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Title or Position | PHARMACIST
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Name | SOFIA 0 FARAH
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Credential |
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Telephone | 832-818-8187
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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