Provider Demographics
NPI:1396031829
Name:FARRELL, JAMES W (RPH)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:W
Last Name:FARRELL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21850 VALENCIA RD
Mailing Address - Street 2:
Mailing Address - City:CUDJOE KEY
Mailing Address - State:FL
Mailing Address - Zip Code:33042-4133
Mailing Address - Country:US
Mailing Address - Phone:305-745-4334
Mailing Address - Fax:858-304-5610
Practice Address - Street 1:21850 VALENCIA RD
Practice Address - Street 2:
Practice Address - City:CUDJOE KEY
Practice Address - State:FL
Practice Address - Zip Code:33042-4133
Practice Address - Country:US
Practice Address - Phone:305-745-4334
Practice Address - Fax:858-304-5610
Is Sole Proprietor?:No
Enumeration Date:2011-06-23
Last Update Date:2011-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN1559672163W00000X
FLPS00173531835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No163W00000XNursing Service ProvidersRegistered Nurse