Provider Demographics
NPI:1235829185
Name:FARRELL, JOSHUA PAUL
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:PAUL
Last Name:FARRELL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:603 HATHAWAY ST
Mailing Address - Street 2:
Mailing Address - City:GRANTSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:26147-8673
Mailing Address - Country:US
Mailing Address - Phone:304-354-9456
Mailing Address - Fax:
Practice Address - Street 1:603 HATHAWAY ST
Practice Address - Street 2:
Practice Address - City:GRANTSVILLE
Practice Address - State:WV
Practice Address - Zip Code:26147-8673
Practice Address - Country:US
Practice Address - Phone:304-354-9456
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-12
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant