Provider Demographics
NPI:1780080085
Name:FARMER, LA KESHA (RPH)
Entity type:Individual
Prefix:MISS
First Name:LA KESHA
Middle Name:
Last Name:FARMER
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 1:2901 LOS FELIZ BLVD
Mailing Address - Street 2:DEPT. 091 (PHARMACY)
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90039-1502
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2901 LOS FELIZ BLVD
Practice Address - Street 2:DEPT. 091 (PHARMACY)
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90039-1502
Practice Address - Country:US
Practice Address - Phone:323-644-5217
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-13
Last Update Date:2014-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA71797183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist