Provider Demographics
NPI:1306179312
Name:FARRER, NICHOLE STRANGE (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:NICHOLE
Middle Name:STRANGE
Last Name:FARRER
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8450 BELLHAVEN BLVD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28216-6103
Mailing Address - Country:US
Mailing Address - Phone:704-392-1369
Mailing Address - Fax:704-394-1390
Practice Address - Street 1:4920-4922 ALBEMARLE RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28205-6103
Practice Address - Country:US
Practice Address - Phone:980-237-4049
Practice Address - Fax:980-237-2967
Is Sole Proprietor?:No
Enumeration Date:2009-09-09
Last Update Date:2018-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC17117183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0608455Medicaid