Provider Demographics
NPI:1427381110
Name:PATTERSON, RUSSELL WARREN (PHARM D)
Entity Type:Individual
Prefix:
First Name:RUSSELL
Middle Name:WARREN
Last Name:PATTERSON
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4320 S NC HIGHWAY 150
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27295-5161
Mailing Address - Country:US
Mailing Address - Phone:336-853-2744
Mailing Address - Fax:336-853-5915
Practice Address - Street 1:4320 S NC HIGHWAY 150
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:NC
Practice Address - Zip Code:27295-5161
Practice Address - Country:US
Practice Address - Phone:336-853-2744
Practice Address - Fax:336-853-5915
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-12
Last Update Date:2009-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC168651835P0018X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist