Provider Demographics
NPI:1962015024
Name:FARROW, CARLO J
Entity Type:Individual
Prefix:
First Name:CARLO
Middle Name:J
Last Name:FARROW
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94-1125 MANINO PL
Mailing Address - Street 2:
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-4022
Mailing Address - Country:US
Mailing Address - Phone:808-983-9288
Mailing Address - Fax:
Practice Address - Street 1:94-1125 MANINO PL
Practice Address - Street 2:
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-4022
Practice Address - Country:US
Practice Address - Phone:808-983-9288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-28
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIH01322911343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)