Philip James Faroh Jr., RPH
Individual provider Active NPI Pharmacist · Wakarusa, IN
NPI 1831797372 · NPPES record last updated Oct 16, 2020
Key facts
- NPI
- 1831797372
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 26023044A (IN)
- Practice address
- 100 N. Elkhart
Wakarusa, IN 46573-2006 - Phone
- (574) 862-1454
- Fax
- (574) 862-4923
- NPI assigned
- Oct 16, 2020
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26023044A | IN | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 26023044A | IN | Yes |
Addresses
Primary practice location
100 N. Elkhart
Wakarusa, IN 46573-2006
Mailing address
112 Penny LN
Trail Creek, IN 46360-6440
Phone (773) 793-5352
Other providers in Wakarusa, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 16, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.