Provider Demographics
NPI:1265877005
Name:FARRY, STACY N
Entity type:Individual
Prefix:MRS
First Name:STACY
Middle Name:N
Last Name:FARRY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:604 FOOTHILLS TRCE
Mailing Address - Street 2:
Mailing Address - City:CHELSEA
Mailing Address - State:AL
Mailing Address - Zip Code:35043-8214
Mailing Address - Country:US
Mailing Address - Phone:205-422-3408
Mailing Address - Fax:
Practice Address - Street 1:MCWHORTER SCHOOL OF PHARMACY SAMFORD
Practice Address - Street 2:800 LAKESHORE DRIVE
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35229-0001
Practice Address - Country:US
Practice Address - Phone:205-726-2008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-07
Last Update Date:2013-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS10601390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program