Russell Glenn Abernathy, RPH
Individual provider Active NPI Pharmacist · Hildebran, NC
NPI 1306138813 · NPPES record last updated Jan 16, 2021
Key facts
- NPI
- 1306138813
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 10857 (NC)
- Practice address
- 300 Main Ave W
Hildebran, NC 28637-8315 - Phone
- (828) 397-3420
- NPI assigned
- May 3, 2011
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10857 | NC | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South Carolina CVS Pharmacy LLC | Past | Accepting new patients | |
| North Carolina CVS Pharmacy LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 10857 | NC | Yes |
Addresses
Primary practice location
300 Main Ave W
Hildebran, NC 28637-8315
Mailing address
301 US 70
Rutherford College, NC 28671
Phone (828) 874-2119
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0125435 | Medicaid | NC |
Other providers in Hildebran, NC
- Leigh Anne Abernathy
- Aruwka, PLLC
- Blue Ridge Healthcare Medical Group, Inc.
- Jesse Rey Nobleza Consing
- Victoria Shelton Craig
- Holly Dula
All providers in Hildebran, NC · Pharmacist in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 16, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.