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NPI Code Detail

MEDICARE: JOHN CALDWELL FARLEY JR.

MEDICARE:   JOHN CALDWELL FARLEY JR.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13747P1801XPersonal Care Attendant

General Provider Information

NPI Number : 1205438934
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN CALDWELL FARLEY JR.
Provider Business Mailing Address
First Line : 5213 WASHINGTON AVE SE
Second Line :
City : CHARLESTON
State : WV
Zip : 25304-2100
Country : US
Telephone Number : 681-222-9923
Fax Number :
Provider Business Practice Location Address
First Line : 5213 WASHINGTON AVE SE
Second Line :
City : CHARLESTON
State : WV
Zip : 25304-2100
Country : US
Telephone Number : 681-222-9923
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/09/2020
Last Update Date : 04/29/2022

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Directions to “ JOHN CALDWELL FARLEY JR. ” Practice Location

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