Provider Demographics
NPI:1740572783
Name:FARNSWORTH, CARRIE J (RPH)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:J
Last Name:FARNSWORTH
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 1:370 S KAYS DR
Mailing Address - Street 2:
Mailing Address - City:KAYSVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84037-4119
Mailing Address - Country:US
Mailing Address - Phone:801-544-8499
Mailing Address - Fax:
Practice Address - Street 1:860 N FAIRFIELD RD
Practice Address - Street 2:
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041-2725
Practice Address - Country:US
Practice Address - Phone:801-546-6352
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-10
Last Update Date:2011-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT2711371701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist