Provider Demographics
NPI:1639244361
Name:FARRAND, LISE C (RPH)
Entity Type:Individual
Prefix:MS
First Name:LISE
Middle Name:C
Last Name:FARRAND
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 SCOTT AVE
Mailing Address - Street 2:
Mailing Address - City:HOOKSETT
Mailing Address - State:NH
Mailing Address - Zip Code:03106-2636
Mailing Address - Country:US
Mailing Address - Phone:603-669-3516
Mailing Address - Fax:
Practice Address - Street 1:129 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-3852
Practice Address - Country:US
Practice Address - Phone:603-271-9427
Practice Address - Fax:603-271-8194
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2395183500000X
MA19151183500000X
FLPS20249183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist