Provider Demographics
NPI:1215188040
Name:RUSSELL, DARIUS LAMONT (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DARIUS
Middle Name:LAMONT
Last Name:RUSSELL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2609 N DUKE ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27704-3048
Mailing Address - Country:US
Mailing Address - Phone:919-220-5121
Mailing Address - Fax:919-220-6307
Practice Address - Street 1:2116 ANGIER AVE STE 103
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27703-4260
Practice Address - Country:US
Practice Address - Phone:919-908-1060
Practice Address - Fax:919-908-6362
Is Sole Proprietor?:No
Enumeration Date:2008-10-10
Last Update Date:2018-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC18330183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist