Provider Demographics
NPI:1336021765
Name:O'FARRELL, DESIREE PATRICIA
Entity type:Individual
Prefix:
First Name:DESIREE
Middle Name:PATRICIA
Last Name:O'FARRELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14379 462ND AVE
Mailing Address - Street 2:
Mailing Address - City:MARVIN
Mailing Address - State:SD
Mailing Address - Zip Code:57251-5208
Mailing Address - Country:US
Mailing Address - Phone:605-216-6668
Mailing Address - Fax:
Practice Address - Street 1:109 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MILBANK
Practice Address - State:SD
Practice Address - Zip Code:57252-1806
Practice Address - Country:US
Practice Address - Phone:605-432-5542
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-25
Last Update Date:2025-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD72831835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy