Mariam Farah

Individual provider Active NPI Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist · Malden, MO

NPI 1942801436 · NPPES record last updated Nov 3, 2020

Key facts

NPI
1942801436
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X
License
2019035649 (MO)
Practice address
1007 N Douglass St
Malden, MO 63863-1515
Phone
(573) 276-5735
NPI assigned
Nov 3, 2020
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2019035649MOMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 2019035649 MO Yes

Addresses

Primary practice location

1007 N Douglass St
Malden, MO 63863-1515

Mailing address

42706 State Highway 25
Malden, MO 63863-9483

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL m0f03x6.s00453@us.wal-mart.com

Other providers in Malden, MO

All providers in Malden, MO · Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Missouri

Sources for this page

Verify at the official NPI Registry.