Provider Demographics
NPI:1912433228
Name:FAMILY PHARMACY LLC
Entity Type:Organization
Organization Name:FAMILY PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PHARMACY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:
Authorized Official - Last Name:PATTERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-817-6794
Mailing Address - Street 1:4316 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:336-242-2668
Mailing Address - Fax:336-242-2673
Practice Address - Street 1:4316 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:336-242-2668
Practice Address - Fax:336-242-2673
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-05
Last Update Date:2017-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy