Active NPI
Nicholas Lee Farrar
- Pharmacy Technician
- Saint Louis, MO
National Provider Identifier
1124329214
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy Technician
- License
- 2009013493
- Practice address
- 2004 McCausland Ave
Saint Louis, MO 63143-2536 - Phone
- (217) 710-0660
- NPI assigned
- Nov 5, 2010
- Last updated
- Nov 5, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy Technician | 183700000X | 2009013493 | MO | Primary |
Addresses
Primary practice location
2004 McCausland Ave
Saint Louis, MO 63143-2536
Mailing address
2004 McCausland Ave
Saint Louis, MO 63143-2536
Phone (217) 710-0660
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2009013493 | MO | MD | Pharmacy Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Missouri LTC Pharmacy LLC | Current | Accepting new patients | |
| Missouri LTC Pharmacy LLC | Current | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Infinium Pharmacy - Republic
- Long Term Care Pharmacy
- Brookline, MO
- NPI 1003327537
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1288915200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1288915200000",
"number": "1124329214",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2004 MCCAUSLAND AVE",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631432536",
"telephone_number": "217-710-0660"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2004 MCCAUSLAND AVE",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631432536",
"telephone_number": "217-710-0660"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FARRAR",
"first_name": "NICHOLAS",
"middle_name": "LEE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-11-05",
"last_updated": "2010-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "183700000X",
"taxonomy_group": "",
"desc": "Pharmacy Technician",
"state": "MO",
"license": "2009013493",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.