Provider Demographics
NPI:1699187765
Name:GREENSBORO FAMILY PHARMACY LLC
Entity Type:Organization
Organization Name:GREENSBORO FAMILY PHARMACY LLC
Other - Org Name:GREENSBORO FAMILY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:WARREN
Authorized Official - Last Name:PATTERSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:336-853-2744
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 1:2290 GOLDEN GATE DR
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405-4302
Practice Address - Country:US
Practice Address - Phone:336-853-2744
Practice Address - Fax:336-853-5915
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-23
Last Update Date:2014-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy