Provider Demographics
NPI:1558703140
Name:OWENS, FARRAH R
Entity Type:Individual
Prefix:MS
First Name:FARRAH
Middle Name:R
Last Name:OWENS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 GILDERVIEW DR
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29681-5238
Mailing Address - Country:US
Mailing Address - Phone:864-787-3909
Mailing Address - Fax:
Practice Address - Street 1:100 GILDERVIEW DR
Practice Address - Street 2:
Practice Address - City:SIMPSONVILLE
Practice Address - State:SC
Practice Address - Zip Code:29681-5238
Practice Address - Country:US
Practice Address - Phone:864-787-3909
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-23
Last Update Date:2013-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide