Provider Demographics
NPI:1447544390
Name:FARRAR, SANDRA LYNN (RPH)
Entity type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:LYNN
Last Name:FARRAR
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1235 E HIGGINS RD
Mailing Address - Street 2:T0880
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-4939
Mailing Address - Country:US
Mailing Address - Phone:847-413-1091
Mailing Address - Fax:847-598-1252
Practice Address - Street 1:1235 E HIGGINS RD
Practice Address - Street 2:T0880
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4939
Practice Address - Country:US
Practice Address - Phone:847-413-1091
Practice Address - Fax:847-598-1252
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-07
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051035503183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist