Provider Demographics
NPI:1689079972
Name:FARRELL, MAUREEN (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:
Last Name:FARRELL
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 LONG HILL RD
Mailing Address - Street 2:
Mailing Address - City:HOLLIS
Mailing Address - State:NH
Mailing Address - Zip Code:03049-5955
Mailing Address - Country:US
Mailing Address - Phone:617-962-0805
Mailing Address - Fax:
Practice Address - Street 1:81 LONG HILL RD
Practice Address - Street 2:
Practice Address - City:HOLLIS
Practice Address - State:NH
Practice Address - Zip Code:03049-5955
Practice Address - Country:US
Practice Address - Phone:617-962-0805
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-29
Last Update Date:2014-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH18174183500000X
NHR1268183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist