Provider Demographics
NPI:1235407149
Name:FARR, LORELEI LUCAS (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LORELEI
Middle Name:LUCAS
Last Name:FARR
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 OLD CORINTH RD
Mailing Address - Street 2:
Mailing Address - City:PETAL
Mailing Address - State:MS
Mailing Address - Zip Code:39465-2932
Mailing Address - Country:US
Mailing Address - Phone:601-705-2896
Mailing Address - Fax:601-583-2374
Practice Address - Street 1:206 OLD CORINTH RD
Practice Address - Street 2:
Practice Address - City:PETAL
Practice Address - State:MS
Practice Address - Zip Code:39465-2932
Practice Address - Country:US
Practice Address - Phone:601-705-2896
Practice Address - Fax:601-583-2374
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-06
Last Update Date:2015-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-0105421835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist