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General NPI Number Information
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NPI Number | 1184635757
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Entity Type | Organization
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Legal Business Name | FARRELL PHARMACY LLC
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Dates
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Enumeration Date | 08/10/2006
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Last Update Date | 10/20/2025
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Provider Practice Location Address
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Address Line | 827 SHARON NEW CASTLE RD
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City | FARRELL
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State | PA
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Zip | 16121-2413
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Country | US
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Telephone | 724-981-4553
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Fax | 724-981-2993
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Provider Business Mailing Address
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Address Line | 30 CONNEAUT LAKE ROAD
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City | GREENVILLE
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State | PA
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Zip | 16125-2167
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Country | US
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Telephone | 724-612-2131
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Fax | 724-981-2993
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Authorized Official
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Title or Position | MEMBER
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Name | BRETTON CLARK WALBERG
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Credential | RPH
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Telephone | 724-612-2131
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PP410710L
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License Number State | PA
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