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
| License | State | Type | Specialty |
|---|---|---|---|
| 2019035649 | MO | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | m0f03x6.s00453@us.wal-mart.com |
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All providers in Malden, MO · Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 3, 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.