Provider Demographics
NPI:1609862549
Name:FARNHAM, CHRISTINE (RPH)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:FARNHAM
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:
Other - Last Name:MUENZBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1711 N COUNTY ROAD 975 E
Mailing Address - Street 2:
Mailing Address - City:LOGANSPORT
Mailing Address - State:IN
Mailing Address - Zip Code:46947-1633
Mailing Address - Country:US
Mailing Address - Phone:574-732-1825
Mailing Address - Fax:574-722-6055
Practice Address - Street 1:800 FULTON ST
Practice Address - Street 2:
Practice Address - City:LOGANSPORT
Practice Address - State:IN
Practice Address - Zip Code:46947-1577
Practice Address - Country:US
Practice Address - Phone:574-722-5600
Practice Address - Fax:574-722-6055
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-26
Last Update Date:2008-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26016327A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist