Provider Demographics
NPI:1982995254
Name:PRICE, PATRICIA S (RPH)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:S
Last Name:PRICE
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 1:4761 WARD BLVD
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27893-4359
Mailing Address - Country:US
Mailing Address - Phone:252-399-2112
Mailing Address - Fax:252-399-2136
Practice Address - Street 1:4761 WARD BLVD
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27893-4359
Practice Address - Country:US
Practice Address - Phone:252-399-2112
Practice Address - Fax:252-399-2136
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-21
Last Update Date:2011-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6703183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist