Provider Demographics
NPI:1891094256
Name:WARE, CRYSTAL PATTERSON (RPH)
Entity Type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:PATTERSON
Last Name:WARE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:144 KESTER DR
Mailing Address - Street 2:
Mailing Address - City:CHERRYVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28021-9317
Mailing Address - Country:US
Mailing Address - Phone:704-487-8201
Mailing Address - Fax:
Practice Address - Street 1:144 KESTER DR
Practice Address - Street 2:
Practice Address - City:CHERRYVILLE
Practice Address - State:NC
Practice Address - Zip Code:28021-9317
Practice Address - Country:US
Practice Address - Phone:704-487-8201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-23
Last Update Date:2011-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12236183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist