Provider Demographics
NPI:1952762585
Name:ALMASSRAF, FARAH
Entity Type:Individual
Prefix:
First Name:FARAH
Middle Name:
Last Name:ALMASSRAF
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 1:6215 SANTA TERESA BLVD
Mailing Address - Street 2:RITE AID PHARMACY
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95119-1436
Mailing Address - Country:US
Mailing Address - Phone:408-227-2816
Mailing Address - Fax:
Practice Address - Street 1:6215 SANTA TERESA BLVD
Practice Address - Street 2:RITE AID PHARMACY
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95119-1436
Practice Address - Country:US
Practice Address - Phone:408-227-2816
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-09
Last Update Date:2016-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA73760183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist