Organization Active NPI

Clemmons Family Pharmacy LLC

Doing business as Tyro Family Pharmacy

  • Community/Retail Pharmacy
  • Lexington, NC
National Provider Identifier
1033343082
Registry record updated Jun 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
CLEMMONS FAMILY PHARMACY LLC
Doing business as
Tyro Family Pharmacy
Practice address
4320 S NC Highway 150
Lexington, NC 27295-5161
Phone
(336) 853-2744
Fax
(336) 853-5915
NPI assigned
May 5, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Russell Warren Patterson, PHARM D
Title
President
Phone
(336) 817-6794

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 10308 NC
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

4320 S NC Highway 150
Lexington, NC 27295-5161

Mailing address

1107 W Market Center Dr
High Point, NC 27260-1642
Phone (336) 817-6794

Other identifiers 1

IdentifierTypeStateIssuer
1033343082MedicaidNC

Other names 1

  • Tyro Family Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091022000089 NC Part B Supplier - Mass Immunization (Roster Biller Only) 4880731983 Practice locations: Lexington, NC

National Provider Directory

National Provider Directory

Locations

4320 S NC Highway 150
Lexington, NC 27295
Phone (336) 853-2744

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1241481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781740800000",
    "number": "1033343082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1107 W MARKET CENTER DR",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272601642",
            "telephone_number": "336-817-6794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4320 S NC HIGHWAY 150",
            "city": "LEXINGTON",
            "state": "NC",
            "postal_code": "272955161",
            "telephone_number": "336-853-2744",
            "fax_number": "336-853-5915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEMMONS FAMILY PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-05",
        "last_updated": "2026-06-18",
        "certification_date": "2026-06-18",
        "status": "A",
        "authorized_official_last_name": "PATTERSON",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "WARREN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "336-817-6794",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM D"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NC",
            "license": "10308",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1033343082",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tyro Family Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Tyro Family Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lexington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.