Provider Demographics
NPI:1578827317
Name:FARLEY, CATHERINE MARIE (PHARMD)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:MARIE
Last Name:FARLEY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:CATHY
Other - Middle Name:MARIE
Other - Last Name:FARLEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:19040 E VALLEY VIEW PKWY
Mailing Address - Street 2:COSTCO PHARMACY #373
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64055-7004
Mailing Address - Country:US
Mailing Address - Phone:816-200-2002
Mailing Address - Fax:816-200-2021
Practice Address - Street 1:19040 E VALLEY VIEW PKWY
Practice Address - Street 2:COSTCO PHARMACY #373
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64055-7004
Practice Address - Country:US
Practice Address - Phone:816-200-2002
Practice Address - Fax:816-200-2021
Is Sole Proprietor?:No
Enumeration Date:2012-06-26
Last Update Date:2012-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2008016517183500000X
KS1-14160183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist