Organization
FARERX LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL DAVID CANGI (CEO)
(484) 401-2551
Entity
Organization
Contact information
Practice address
444 N 3RD ST STE 106, PHILADELPHIA, PA 19123-4141
(267) 662-1528
Mailing address
444 N 3RD ST STE 106, PHILADELPHIA, PA 19123-4141
(267) 662-1528
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
—
—
174200000X
Meals Provider
Primary
—
—
335G00000X
Medical Foods Supplier
—
—
Other
Enumeration date
03/27/2024
Last updated
03/27/2024
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