MEDICARE: MARCUS FARREL ANTHONY RPH

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	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	03124487	OH
2	183500000X	Pharmacist	03124487	OH

General Provider Information

NPI Number	:	1508513946
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARCUS FARREL ANTHONY RPH

Provider Business Mailing Address
First Line	:	825 BLUFFVIEW DR
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43235-1727
Country	:	US
Telephone Number	:	614-266-2511
Fax Number	:	614-732-5840

Provider Business Practice Location Address
First Line	:	2343 CLEVELAND AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43211-1611
Country	:	US
Telephone Number	:	614-388-8088
Fax Number	:	614-732-5840

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

Provider Enumeration Date	:	03/06/2022
Last Update Date	:	03/06/2022

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