Provider Demographics
NPI:1669716650
Name:FARR, MISTY COLLIER (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MISTY
Middle Name:COLLIER
Last Name:FARR
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:MISTY
Other - Middle Name:KATRICE
Other - Last Name:COLLIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:1327 HARTING DR
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63031-1977
Mailing Address - Country:US
Mailing Address - Phone:314-716-2959
Mailing Address - Fax:
Practice Address - Street 1:1327 HARTING DR
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63031-1977
Practice Address - Country:US
Practice Address - Phone:314-716-2959
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-15
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010027743183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist