Provider Demographics
NPI:1457505208
Name:FARLEY, T. MICHAEL (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:T. MICHAEL
Middle Name:
Last Name:FARLEY
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:THOMAS
Other - Middle Name:MICHAEL
Other - Last Name:FARLEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:500 E MARKET ST
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52245-2633
Mailing Address - Country:US
Mailing Address - Phone:319-688-7214
Mailing Address - Fax:319-887-2931
Practice Address - Street 1:500 E MARKET ST
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52245-2633
Practice Address - Country:US
Practice Address - Phone:319-688-7214
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-06
Last Update Date:2016-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA206551835P1200X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA420680391Medicaid