MEDICARE: LORI ELIZABETH FARQUHAR

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
1	183500000X	Pharmacist	038040	NY

General Provider Information

NPI Number	:	1235342155
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORI ELIZABETH FARQUHAR

Provider Business Mailing Address
First Line	:	6751 PINE GROVE RD
Second Line	:
City	:	GLENFIELD
State	:	NY
Zip	:	13343-1812
Country	:	US
Telephone Number	:	315-376-1917
Fax Number	:

Provider Business Practice Location Address
First Line	:	6805 MCALPINE ST
Second Line	:
City	:	LYONS FALLS
State	:	NY
Zip	:	13368
Country	:	US
Telephone Number	:	315-348-8121
Fax Number	:	315-348-6120

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/07/2007
Last Update Date	:	07/08/2007

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