1598760399 NPI number — MISS MARILYN OLUFUNSHO FARINRE RPH., MBA

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598760399 NPI number — MISS MARILYN OLUFUNSHO FARINRE RPH., MBA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FARINRE
Provider First Name:
MARILYN
Provider Middle Name:
OLUFUNSHO
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
RPH., MBA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1598760399
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
17522 CHESTNUT TRL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RICHMOND
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77469-7594
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-277-2715
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
LYNDON BAINES GENERAL HOSPITAL PHARMACY
Provider Second Line Business Practice Location Address:
5656 KELLEY STREET
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77026-1967
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-566-5140
Provider Business Practice Location Address Fax Number:
713-566-5151
Provider Enumeration Date:
06/17/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  40431 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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