Organization
SOUTH PARK FAMILY PHARMACY LLC
Active
Other names
South Park Family Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
RUSSELL WARREN PATTERSON PHARM D. (MEMBER/MANAGER)
(336) 817-6794
Entity
Organization
Contact information
Practice address
1215 A WEST CLEMMONSVILLE ROAD, WINSTON-SALEM, NC 27127-4790
(336) 853-2744
(336) 853-5915
Mailing address
1107 W MARKET CENTER DR, HIGH POINT, NC 27260-1642
(336) 817-6794
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
11570
NC
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1295173573
—
NC
Enumeration date
06/10/2013
Last updated
06/18/2026
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