Provider Demographics
NPI:1144907494
Name:FARRAR, VIDA A (PHD, RPH)
Entity type:Individual
Prefix:DR
First Name:VIDA
Middle Name:A
Last Name:FARRAR
Suffix:
Gender:F
Credentials:PHD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1231 NE MAYNARD RD STE A
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-4175
Mailing Address - Country:US
Mailing Address - Phone:919-653-0810
Mailing Address - Fax:
Practice Address - Street 1:1231 NE MAYNARD RD STE A
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-4175
Practice Address - Country:US
Practice Address - Phone:919-653-0810
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-29
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC15071183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist