Provider Demographics
NPI:1255424933
Name:FARINA, JOHN JOSEPH (RPH)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:JOSEPH
Last Name:FARINA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 BELMONT AVE
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:ME
Mailing Address - Zip Code:04346
Mailing Address - Country:US
Mailing Address - Phone:207-582-4536
Mailing Address - Fax:
Practice Address - Street 1:ONE VA CENTER
Practice Address - Street 2:
Practice Address - City:TOGUS
Practice Address - State:ME
Practice Address - Zip Code:04330
Practice Address - Country:US
Practice Address - Phone:207-623-8411
Practice Address - Fax:207-623-5738
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH7154284300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes284300000XHospitalsSpecial Hospital