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General NPI Number Information
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NPI Number | 1649932708
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Entity Type | Individual
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Provider Name | ERIC LEE FARTHING JR. PHARMD
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Gender | Male
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Dates
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Enumeration Date | 10/06/2021
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Last Update Date | 10/06/2021
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Provider Practice Location Address
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Address Line | 3340 S GRAND BLVD
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City | SAINT LOUIS
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State | MO
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Zip | 63118-1017
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Country | US
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Telephone | 314-772-5722
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Fax |
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Provider Business Mailing Address
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Address Line | 8927 CHICKASAW DR
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City | SAINT LOUIS
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State | MO
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Zip | 63132-2311
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Country | US
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Telephone | 573-281-5443
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 2017025928
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License Number State | MO
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