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Organization
KENNETH FARHA
Active
Organization
KENNETH FARHA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH FARHA D.D.S. (OWNER)
(334) 260-0501
Entity
Organization
Contact information
Practice address
2640 BELL RD, MONTGOMERY, AL 36117-4375
(334) 260-0501
Mailing address
2640 BELL RD, MONTGOMERY, AL 36117-4375
(334) 260-0501
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
3754
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000092046
MEDICARE PTAN
AL
01
—
1891887568
INDIVIDUAL NPI
—
Enumeration date
11/11/2010
Last updated
12/03/2010
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